Study of treatment options in stricture urethra management and success rate in different types and sites of stricture


  • Krishna Rao S. V. Department of Urology, Katuri Medical College, Guntur, Andhra Pradesh, India
  • Preetam Penumatcha Department of Urology, Katuri Medical College, Guntur, Andhra Pradesh, India



Buccal mucosal graft, Stricture, Urethroplasty, Urethrotomy


Background: A urethral stricture is a scar of the subepithelial tissue of the corpus spongiosum that constricts the urethral lumen. As the constriction progresses, obstruction develops and leads to symptoms either directly related to the obstruction or as a secondary consequence.

Methods: All the cases of stricture urethra presented to our institute between June 2017 to June 2019 (n=60) in whom treatment was required were studied in a prospective manner. All cases of obstructive voiding symptoms are evaluated by conducting uroflowmetry studies (ESPON, gravimetric type). Obstructive voiding symptoms are evaluated by using the American Urological Association questionnaire.

Results: The data collected was divided into 3 groups: infective causes of stricture (n=22), traumatic causes of stricture (n=14) and idiopathic causes of stricture (n=24). The mean age of presentation was 34.4 years (range of 20 to 50 years). 18 (30.00%) patients had stricture in the bulbo-urethra, 12 (20.00%) at the external meatus, 4 patients had stricture at the bulbo-membranous region. Procedures undertaken during the study were visual internal urethrotomy in 20, anastomotic urethroplasty in 17 patients and Augmented urethroplasty in 23 patients. In our series of 60 patients, 48 patients had a Qmax of >15 ml/sec.  Average success rate was 80.1%, 12 patients had a Qmax of <15 ml/sec.

Conclusions: It is unwise to make sweeping recommendations for best practice for reconstructive urethral surgery based on the literature because each patient clearly requires an individualized approach based on individual circumstances. Buccal mucosa is the most widely used graft has excellent results in all types of urethroplasty.


Chapple CH, Barbagli G, Jordan G, Mundy AR, Rodrigues‐Netto N, Pansadoro V, et al. Consensus statement on urethral trauma. BJU Inter. 2004;93(9):1195-202.

Das S. Shusruta of India, the pioneer in the treatment of urethral stricture. Surg Gynecol Obstet. 1983;157:581-2.

Arnott J. A Treatise on Stricure of the Urethra. London: Burgess and Hill; 1819.

McMillan A, Pakianathan M, Mao NH, Macintyre CC. Urethral stricture and urethritis in men in Scotland. Genitourin Med. 1994;70:403-5.

Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol. 2007;177:1667-74.

Beard DE, Goodyear WE. Urethral stricture; a pathological study. J Urol. 1948;59:619-26.

Fenton AS, Morey AF, Aviles R, Garcia CR. Anterior urethra strictures: etiology and characteristics. Urol. 2005;65:1055-8.

Lumen N, Hoebeke P, Willemsen P, De Troyer B, Pieters R, Oosterlink W. Etiology of urethral stricture disease in the 21st century. J Urol. 2009;182:983-7.

Netto NR Jr. Martucci RC, Goncalves ES, Freire JG. Congenital stricture of male urethra. Intl Urol Nephrol. 1976;1:55-61.

Barbagli G, Palminteri E, Rizzo M. Dorsal onlay graft urethroplasty using penile skin or buccal mucosa in adult bulbourethral strictures. J Urol. 1998;160;1307-9.

Riordan O, Morey AF, Aviles R, Garcia CR. Urethral strictures: etiology and characteristics. Urol. 2006;65:1055-8.

Kulkarni K, Jordan G. Consensus statement on urethral Stricture. BJU Int. 2003;93:1195-202.






Original Research Articles