Surgical treatment of urethral strictures. A personal view

This article is the text of a state of the art paper presented at the congr ess of the Societe Francaise d'Urologie in Paris in November 1999. The author expressed his personal Views on the indications advantages and d isadvantages of current techniques for the treatment of urethral stricture in men, such as: endoscopic urethrotomy, end-to-end anastomosis, prepuce or oval mucosa free grafts, penile or scrotal pedicled flaps, expansible meta l stents and two-stage urethroplasties. Apart from his own personal experie nce, he bases his discussion on the pathophysiology of healing and, often o ld data of the literature concerning surgery of the urethra. He critically reviews recent developments: the posterior approach to urethr al stricture and temporary stents. Finally, he presents two personal techni ques: endoscopic urethroplasty with free graft around a biodegradable stent and the use of a pudendal fascio-cutaneous flap to correct large perineal defects.