Management Of Urethral Strictures Research Articles

Bulbar urethroplasty techniques and stricture recurrence: differences between end-to-end urethroplasty versus the use of graft.

Urethral stricture (US) affects most commonly the anterior portion of the urethra, concretely the bulbar, with a significant incidence in men. Open urethroplasty is the gold standard treatment. However, stricture recurrence (SR) remains a current subject of concern. The aim of the present review is to provide an updated literature summary on surgical urethroplasty techniques for bulbar US and prognostic factors for SR, comparing the different approaches. For short strictures, excision and primary anastomosis (EPA) is the preferred option, with success rates exceeding 90%. Substitution techniques are usually required for longer strictures (>2-3cm). Buccal mucosa graft (BMG) remains the first choice as it complies with ideal features, with no significant differences regarding the site of graft implantation. Stricture length, time since urethroplasty and number of previous urethral interventions are risk factors for failure. Also, surgeon's experience affects technique selection and future outcomes. There seems to be consensus on a higher SR rate following substitution techniques compared to EPA, which appears to be influenced by the stricture length, usually longer in the former group. Furthermore, there is a trend in favor of endoscopic management of SR, except for long and complex recurrences where grafts should be used. In conclusion, multiple urethroplasty techniques are available and selection must be carefully individualized, focusing on stricture characteristics, patient's history, and surgeon's experience. Well-designed studies with clear definitions and follow up protocols are still necessary to develop standardized guidelines on the management of bulbar US.

Comparative analysis of holmium: YAG laser internal urethrotomy versus Cold-Knife optical internal urethrotomy in the management of urethral stricture: A systematic review and Meta-Analysis.

Urethral stricture management has posed enduring challenges in urology, demanding innovative and effective treatment modalities. This study addresses the persistent issues associated with urethral strictures, focusing on the comparative evaluation of two contemporary treatment modalities: Ho: YAG Laser Internal Urethrotomy (HIU) and Cold Knife Optical Internal Urethrotomy (CIU). A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library and ResearchGate was conducted to identify relevant studies up to November 2023. Inclusion criteria encompassed comparative studies evaluating HIU and CIU in patients with urethral stricture. Data extraction, quality assessment, and subgroup analyses were performed using standardized methods. Outcome measures included preoperative and postoperative mean the maximum urine flow rate (Qmax), mean surgical time, recurrence rates, and perioperative complications. Nine articles met the inclusion criteria, and their data were analyzed using RevMan 5.4.1. Forest plots were generated for preoperative and postoperative mean Qmax, mean surgical time, recurrence rates, and perioperative complications. While postoperative mean Qmax (MD -0.06; 95% CI, -0.28-0.16; P=0.60, I2=75%) and mean surgical time (MD 2.16; 95% CI, -1.66-5.99; P=0.27, I2=98%) showed no significant differences between HIU and CIU, a trend towards lower recurrence rates (RR 0.71; 95% CI, 0.48-1.06; P=0.09, I2=46%) was observed with HIU but without statistical significance. Perioperative complications, particularly bleeding (RR 0.21; 95% CI, 0.08-0.53; P=0.001, I2=0%), favored HIU over CIU. The subanalysis indicates that for the treatment of complex urethral strictures, the two surgical methods differ in terms of mean Qmax at 6 months postoperatively (MD -2.51; 95% CI, -4.10--0.91; P=0.002, I2=59%) and 12 months postoperatively (MD 2.62; 95% CI, 0.93-4.30; P=0.002, I2=0%). The HIU group shows a significant decrease in recurrence rate at 12 months postoperatively (RR 0.44; 95% CI, 0.21-0.92; P=0.03, I2=0%). For short-segment urethral strictures with a length ≤1.5cm, CIU had a shorter operative time compared to the HIU (MD 4.49; 95% CI, 3.87-5.10; P<0.00001, I2=44%). Overall, both interventions demonstrated similar efficacy in improving postoperative mean Qmax, mean surgical time and recurrence rates. However, subanalysis indicates that in the short term, CIU is more effective than HIU in improving Qmax after complex urethral stricture surgery. In long-term Qmax follow-up after surgery, HIU is significantly higher than CIU, and HIU has a low recurrence rate. In addition, for short-segment urethral stricture (≤1.5cm), CIU requires less time. In terms of complications, HIU has a lower risk of bleeding.

Incidence and management of BPH surgery-related urethral stricture: results from a large U.S. database.

Urethral stricture (US) is a well-known complication after surgical treatment of benign prostatic hyperplasia (BPH). This study aimed to evaluate the contemporary incidence of the US after different types of BPH surgery, to identify associated risk factors and to assess its management. A retrospective analysis was conducted using the PearlDiver™ Mariner database, containing de-identified patient records compiled between 2011 and 2022. Specific International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were employed to identify population characteristics and outcomes. All the most employed surgical procedures for BPH treatment were considered. Multivariable logistic regression was employed to evaluate factors associated with diagnosis of post-operative US. Among 274,808 patients who underwent BPH surgery, 10,918 developed post-operative US (3.97%) within 12 months. Higher incidence of US was observed following TURP (4.48%), Transurethral Incision of the Prostate (TUIP) (3.67%), Photoselective Vaporization of the Prostate (PVP) (3.92%), HoLEP/ThuLEP (3.85%), and open Simple Prostatectomy (SP) (3.21%). Lower incidence rates were observed after laparoscopic\robot-assisted SP (1.76%), Aquablation (1.59%), Prostatic Urethral Lift (PUL) (1.07%), Rezum (1.05%), and Prostatic Artery Embolization (PAE) (0.65%). Multivariable analysis showed that patients undergoing PUL, Rezum, Aquablation, PAE, and PVP were associated with a reduced likelihood of developing US compared to TURP. US required surgical treatment in 18.95% of patients, with direct visual internal urethrotomy (DVIU) and urethroplasty performed in 14.55% and 4.50% of cases, respectively. Urethral dilatation (UD) in an outpatient setting was the primary management in most cases (76.7%). The present analysis from a contemporary large dataset suggests that the incidence of US after BPH surgery is relatively low (<5%) and varies among procedures. Around 94% of US cases following BPH surgery are managed using minimally invasive treatment approaches such as UD and DVIU.

Role of Kshara Tail Uttarbasti in the management of Urethral Stricture - A Case Study

Stricture urethra, though a rare condition, still is a rational and troublesome problem in the international society. The symptoms like obstructed urine flow, straining, dribbling and prolongation of micturition. Major complications caused by this disease are obstructed urine flow, urine stasis leading to urinary tract infection, calculi formation, etc. This condition can be correlated with Mutramarga Sankocha in Ayurveda. Modern medical science suggests urethral dilatation, which may cause bleeding, false passage and fistula formation in few cases. Surgical procedures have their own complications and limitations. Uttarabasti, a para-surgical procedure is the most effective available treatment in Ayurveda for the diseases of Mutravaha Strotas.

Double faced buccal mucosal graft urethroplasty for near obliterative inflammatory urethral stricture: a retrospective study comparing two different techniques

Background: Double-faced urethroplasty offers improved outcomes for the management of complex urethral strictures. In our study, we compared two different techniques of double faced buccal mucosal graft (BMG) urethroplasty. Methods: 46 patients who underwent double faced BMG urethroplasty at Ramaiah Medical College were retrospectively reviewed and grouped into A (Enzo Palminteri technique) and B (Joel Gelman technique). Post operatively, patients were followed up with AUA-SS, uroflowmetry and postvoid residual assessment. The data analysis was done using the statistical package for the social sciences (SPSS) version 21.0. A p&lt;0.05 was considered statistically significant. Results: 24 patients belonged to group A and 22 patients belonged to group B. The mean stricture length measured was 4.42±1.632 cm in group A and 4.11±1.634 cm in group B with the preoperative mean Qmax and AUA score was 7±1.318 ml/s and 19.75±3.286 in group A and 7.3±1.497 ml/s and 18.68±3.469 in group B. Mean operative time was 162.7±12.156 minutes versus 181.36±7.429 minutes. Group A patients had significant intraoperative blood loss. Recurrence was noted in two patients, one from each group. Mean Qmax and mean AUA score at recent follow up was 19.3±1.63 ml/s and 6.4±2.10 versus 19.8±1.59 ml/s and 6.6±2.03 for group A and group B with a mean follow up of 36.6±12.63 months and 36.8±11.48 months respectively. Conclusions: Double faced BMG urethroplasty for near obliterative urethral stricture is safe, efficacious with ventral onlay associated with lesser operative time.

Management of Anterior Urethral Stricture: A Survey of Contemporary Practice of Iranian Urologists.

To evaluate Iranian urologists' approach to urethral stricture and assess how often they select open urethroplasty over minimally invasive procedures. This cross-sectional observational study was conducted via www. porsline.ir among members of the Iranian urologists' community. The urologists were contacted via email and social media applications (e.g., WhatsApp, Telegram), and data, including their demographic information and years of practice, as well as questions related to their attitude towards the management of urethral stricture, were collected. A total number of 376 patients were included in the current survey. The specialty of reconstructive urology was selected by less than 2% (n=5) as their field of interest. Only 6.64% (n=25) of the urologists stated that they received adequate training for management of urethral stricture. Only about 5% (n=19), believed that according to scientific resources, chose open urethroplasty as the initial management. Almost 94% (n=353) did not perform any urethroplasties during the past year and about 0.2% (n=2) performed more than 20 open urethroplasties. For diagnosing urethral stricture, almost 99% of them chose RUG+VCUG, 72% chose urethrocystoscopy, and 69% chose uroflowmetry in the third place. For evaluation of urethroplasty postoperative outcomes, 76% (n=269) used RUG+VCUG, 15% (n=56) used Rigid Cystoscopy, and 8% (n=29) used Flexible Cystoscopy, Conclusion: Iranian urologists prefer minimally invasive procedures for treating urethral stricture, similar to other countries. This lack of urologists' interest in open urethroplasty is greatly due to poor training during the residency years and little experience with urethral strictures. Therefore, further considerations in order to improve urologists' knowledge and expertise for management of urethral stricture is recommended.

Acellular dermal matrix in urethral reconstruction.

The management of severe urethral stricture has always posed a formidable challenge. Traditional approaches such as skin flaps, mucosal grafts, and urethroplasty may not be suitable for lengthy and intricate strictures. In the past two decades, tissue engineering solutions utilizing acellular dermal matrix have emerged as potential alternatives. Acellular dermal matrix (ADM) is a non-immunogenic biological collagen scaffold that has demonstrated its ability to induce layer-by-layer tissue regeneration. The application of ADM in urethral reconstruction through tissue engineering has become a practical endeavor. This article provides an overview of the preparation, characteristics, advantages, and disadvantages of ADM along with its utilization in urethral reconstruction via tissue engineering.

Balloon dilation for the treatment of male urethral strictures: a systematic review and meta-analysis

ObjectiveThe use of minimally invasive endoluminal treatment for urethral strictures has been a subject for debate for several decades. The aim of this study was to review and discuss the...

Transperineal anastomotic posterior urethroplasty with bulbocavernosus flap and fibrin sealant in the complicated posterior urethral stricture reconstruction: a retrospective cohort study.

Management of complicated posterior urethral stricture is challenging. Modified transperineal anastomotic urethroplasty (TAU) with bulbocavernosus flap interposition and human fibrin sealant provides another treatment option. The authors aimed to evaluate whether this technique could improve the success rate in the complicated posterior urethral stricture reconstruction in this study. Between 2016 and 2019, 48 patients underwent either conventional or modified TAU. The criteria for success included both the absence of clinical symptoms and no need for further surgical intervention during follow-up. Twelve patients underwent the modified TAU (group A) using bulbocavernosus flap interposition and human fibrin sealant. Thirty-six patients underwent the traditional end-to-end anastomotic urethroplasty (group B). Follow-up was 24.3-57.2 months. The patients in group A had a higher surgery success rate compared to the patients in group B (91.7 vs. 63.9%, P =0.067), with a quasi-significant result. Besides, no postoperative complications were observed in group A, while two individuals in group B had urinary incontinence, but the difference was not significant (0 vs. 5.6%, P =0.404). Based on the preliminary results, modified TAU with bulbocavernosus flap interposition and human fibrin sealant is a safe and feasible technique for complicated posterior urethral stricture reconstruction.

Evaluation and management of urethral strictures-guideline summary 2024 : part1-anterior urethra

In recent years, several international urological societies have published guidelines on the diagnosis, treatment, and follow-up of urethral strictures, but aguideline for the German-speaking region has not been available to date. This summary provides adetailed comparison of the guidelines of the European Association of Urology (EAU), American Urological Association (AUA) and the Société Internationale d'Urologie (SIU) with regard to the treatment of anterior urethral strictures, i.e. from the bulbar urethra to the meatus. In the following work, differences and specific recommendations in the guidelines are highlighted. In particular, the three guidelines largely agree with regard to diagnostic workup and follow-up. However, divergences exist in the management of anterior urethral strictures, particularly with regard to the use of endoscopic therapeutic approaches and the use of urethral stents. In addition, the EAU provides more comprehensive and detailed recommendations on urethroplasty techniques and specific patient follow-up. The EAU guidelines are the most current and were the first to include instructions for urethral strictures in women and individuals with gender incongruence after genital approximation surgery. Reconstructive urology is arapidly evolving specialty and, thus, the clinical approach has been changing accordingly. Although guideline recommendations have become more inclusive and comprehensive, more high-quality data are needed to further improve the level of evidence.

Optilume drug-coated balloon for anterior urethral stricture: 2-year results of the ROBUST III trial.

The aim of this study is to report the updated 2-year results of the intervention arm of the ROBUST III randomized trial evaluating the safety and efficacy of the Optilume drug-coated balloon (DCB) versus standard endoscopic management of recurrent male anterior urethral stricture. Eligible patients included men with recurrent anterior urethral stricture ≤3cm in length and ≤12Fr in diameter, International Prostate Symptom Score (IPSS) ≥11 and peak flow rate (Qmax) <15 mL/s. Patients were randomized to treatment with the Optilume DCB or standard-of-care endoscopic management. Primary efficacy endpoints measured at 2years included freedom from re-intervention and changes in IPSS, Qmax and post-void residual (PVR). Secondary endpoint was impact on sexual function using the International Index of Erectile Function (IIEF). Primary safety endpoint was freedom from serious procedure- or device-related adverse events (AEs). A total of 127 patients enrolled at 22 sites in the United States and Canada (48 randomized to standard-of-care dilation and 79 to DCB dilation). Seventy-five patients in the DCB arm entered the open-label phase after 6 months. Participants averaged 3.2 prior endoscopic interventions (range 2-10); most (89.9%) had bulbar strictures with an average stricture length of 1.63 cm (SD 0.76). Significant improvements in IPSS, average Qmax and PVR were maintained at 2years. Freedom from repeat intervention was significantly higher in the Optilume DCB arm at 2years versus the Control arm at 1year (77.8% vs. 23.6%, p < 0.001). During the follow-up period, there were 15 treatment failures and two non-study-related deaths. Treatment-related AEs were rare and generally self-limited (haematuria, dysuria and urinary tract infection). The Optilume DCB shows sustained improvement in both objective and subjective voiding parameters at 2-year follow-up. Optilume appears to provide a safe and effective endoscopic treatment alternative for short recurrent anterior urethral strictures among men who wish to avoid or delay formal urethroplasty.

Retrospective assessment of quality of life impact and patient-reported outcomes in urethral stricture management: Insights from a tertiary hospital in Portugal

Retrospective assessment of quality of life impact and patient-reported outcomes in urethral stricture management: Insights from a tertiary hospital in Portugal

Etiology, diagnostic pathway and treatment of urethral strictures in men

Etiology, diagnostic pathway and treatment of urethral strictures in men

Circular Penile Skin Fasciocutaneous Ventral Onlay Flap Urethroplasty as an Alternative to Dorsal Onlay Buccal Mucosal Graft Urethroplasty in Complex Long-Segment Urethral Stricture: A Retrospective Study.

Background A urethral stricture is the narrowing of the urethra that results in symptoms of obstruction. It can appear anywhere along the male urethra's length and has a variety of causes.The circular penile fasciocutaneous flap is employed in the successful single-stage reconstruction of long-segment complex anterior urethral strictures especially when the buccal mucosa is unavailable due to various reasons.The study has tried to identify a surgical technique that is more beneficial for the treatment of urethral strictures. Objective The objective of this research was to evaluate the outcomes of circular penile skin fasciocutaneous ventral onlay flap urethroplasty (group A) and the outcomes of dorsal onlay buccal mucosal graft urethroplasty (group B) in the management of complex long-segment penile urethral stricture. Methods In this retrospective study between December 2012 and December 2022, 60 patients with long-segment complex penile urethral stricture who underwent urethroplasty at our center were evaluated. Patients were divided into two groups according to the flap used (dorsal onlay buccal mucosal graft urethroplasty was used in 30 patients (group B), and circularpenile fasciocutaneous flap (single stage) was used in 30 patients (group A)). The success rate and the mean peak flow rate were also calculated post-operation to identify the effectiveness of the surgical procedure used for urethral strictures. Results The study consisted of 60 patients in total. Group A's mean age was determined to be 51.2±16.2 years, whereas group B's mean age was determined to be 40.7±16.8 years. Preoperatively, the median urethral stricture length was 69 mm in group A (range: 20-100 mm) and 56 mm in group B (range: 30-110 mm). The intraoperative median length of the urethral stricture was 82 mm in group A (range: 20-120 mm) and 65 mm in group B (range: 40-140 mm). The mean peak flow rate was 30.9±6.8mL/s in group A compared to 18.1±4.9mL/s in group B. The success ratefor group A was 89.7%, while the success rate forgroup Bwas 75.9%. Conclusion For complexlong-segment urethral strictures, circular penile skin fasciocutaneous ventral onlay flap urethroplasty has a higher rate of success and fewer complications than dorsal onlay buccal mucosal graft urethroplasty. Along with success rate, it has a better mean peak flow rate and lower complications.

Retrograde sagittal urethrography in diagnostics of urethral stricture disease: shifting the focus

Background. For over a century retrograde urethrography (RUG) has offered the key method to diagnose urethral stricture (US). The disadvantage of the technique, however, is a potential high risk to underestimate the stricture length due to distorted visualization and eventual flawed surgical planning.Aim. To consider retrograde sagittal urethrography (RSU) and how it contributes to enhancing US preoperative diagnostics and treatment efficacy in clinical practice.Materials and methods. We compared the protocols of pre-op urethrograms performed by a radiologist and a urologist to surgery protocols for both patient groups. Group 1 included 154 patients who underwent US surgical treatment from 2017 to 2021 after using RSU as a diagnostic method (positioning 90°). Group 2 comprised 142 patients presented with identical disease who received surgery between 2012 to 2016 in our hospital after RUG using traditional technique (positioning 45°). Discrepancies of 5 mm and over in stricture length measurements between radiography protocols and intraoperative data were considered a diagnostic flaw (i.e. inconsistency). Treatment efficacy was compared across both groups.Results. In 87.6 % of cases in Group 1 (RSU) protocols provided by a radiologist matched intraoperative data versus45.7 % of cases receiving accurate protocol data in Group 2 (RUG) (χ2 = 59.15, p &lt;0.001). Urethrogram protocols prepared by a urologist pre-operatively were accurate in 95.4 % of cases in Group 1 versus 62.0 % in Group 2 (χ2 = 49.11, p &lt;0.001). The overall efficiency of surgery was higher in Group 1 (91.6 %), than in Group 2 (82.4 %) (χ2 = 5.54, p &lt;0.01).Conclusion. RSU is an innovative technique that allows to significantly improve the accuracy of urethral stricture length measurement, resulting in greater treatment efficiency in Group 1 of patients. The proposed urethrographic technique can be recommended as a basic diagnostic procedure for anterior US in men.

Safety and Feasibility Study of Autologous Engineered Urethral Constructs for the Treatment of Strictures: Clinical Trial Update

Autologous engineered urethral constructs are a promising treatment option for definitive management of long and complex urethral strictures, with the prospect of eliminating stricture recurrence.

Магнитно-резонансная томография в диагностике стриктуры уретры.

Introduction. In order to improve the results of surgical treatment of urethral stricture in men, it is extremely important to accurately diagnose preoperative changes. From this point of view, it seems promising to use magnetic resonance imaging (MRI) in the urethral stricture diagnosis, the assessment of which is the subject of this literature review. Materials and methods. The review is based on articles published throughout history in scientific peer-reviewed journals included in the databases PubMed (https://www.ncbi.nlm.nih.gov/pubmed/), Scopus (https://www.scopus.com/), Scientific Electronic Library eLibrary.ru (https://elibrary.ru/). The search was performed on the following keywords: «magnetic resonance imaging», «MRI», «urethral stricture», «urethral obliteration», «urethral stenosis», «urethral injury», «urethral distraction defect», «urethroplasty», «urethral reconstruction», «urethral surgery», «pelvic fracture». At the first stage, 308 sources were found, of which 23 articles were included in the review. Results. A total of 23 original studies were identified in which MRI was used for urethral stricture in men, of which 2 were Russian studies. Four studies evaluated only anterior urethral strictures, 10 studies evaluated posterior urethral strictures, and 9 studies – both anterior and posterior urethral strictures. These studies included 10 to 121 patients with urethral stricture (mean 42 patients). MRI generally provides more accurate information on the extent of the stricture, the nature of spongiofibrosis and other periurethral changes, the presence of concomitant pathology compared to traditional methods for diagnosing urethral stricture. Conclusions. MRI for urethral stricture provides additional information for treatment planning. However, given the high cost of the method and a small number of works, further research is needed to obtain sufficient grounds for the widespread clinical use of MRI in urethral stricture.

Complications after Prostate Cancer Treatment: Pathophysiology and Repair of Post-Radiation Urethral Stricture Disease.

Radiation therapy (RT) in the management of pelvic cancers remains a clinical challenge to urologists given the sequelae of urethral stricture disease secondary to fibrosis and vascular insults. The objective of this review is to understand the physiology of radiation-induced stricture disease and to educate urologists in clinical practice regarding future prospective options clinicians have to deal with this condition. The management of post-radiation urethral stricture consists of conservative, endoscopic, and primary reconstructive options. Endoscopic approaches remain an option, but with limited long-term success. Despite concerns with graft take, reconstructive options such as urethroplasties in this population with buccal grafts have shown long-term success rates ranging from 70 to 100%. Robotic reconstruction is augmenting previous options with faster recovery times. Radiation-induced stricture disease is challenging with multiple interventions available, but with successful outcomes demonstrated in various cohorts including urethroplasties with buccal grafts and robotic reconstruction.

Holmium laser versus cold knife visual internal urethrotomy for management of short segment urethral stricture: a prospective randomized clinical trial

ObjectivesTo report the safety and efficacy of holmium laser and compare its results with cold knife visual internal urethrotomy (VIU) in the management of short segment urethral stricture.MethodsThis prospective randomized study included 66 male patients aged more than 18 years, with short segment bulbar urethral strictures < 2 cm from March 2020 to March 2022. The patients were randomized into two groups each containing 33 patients. In group A (Cold knife group), Sachse cold knife was used for stricture treatment. In group B (Holmium group), internal urethrotomy was done with Ho:YAG laser. Patients were evaluated before the operation and followed up after the operation at 1, 3, 6 and 12 months by physical examination, IPSS, PVR, Qmax and retrograde urethrography.ResultsThere was significant improvement in the mean values of IPSS, PVR and Qmax in both groups. There was no significant difference between both groups in the mean values of IPSS, PVR and Qmax during follow-up visits. However, at the end of follow-up at one year there was statistically significant difference between both groups in the mean values of IPSS, PVR and Qmax due to higher recurrence rate in cold knife group than laser group. The overall complication rate is significantly lower in laser group (p = 0.014).ConclusionHolmium laser VIU is an effective and safe treatment option for short segment urethral stricture with shorter operative time, less complication rate and less recurrence than cold knife VIU.

Outcome of Urethroplasty in Management of Urethral Stricture: Experience at Institute of Kidney Diseases Hayatabad Peshawar

Objective: To determine the frequency of successful outcomes of urethroplasty in the management of urethral stricture Methods: It is a descriptive study, conducted in the department of Urology at the Institute of Kidney diseases Peshawar from April 2016 to December 2019. A total number of 85 patients for urethroplasty were included in the study by non-probability convenient sampling. The entire pre-operative, per-operative, and postoperative data were collected on structured proforma and analyzed on SPSS®, version 20.0. Results: The mean age of the patient in this study was 41 years. Regarding etiology, External trauma was the major cause in the form of road traffic accidents in 38.82% while straddle urethral injury in 29.41% of patients, other less frequent causes included iatrogenic urethral trauma and infective stricture. The bulbar urethral stricture was found in 55.29% of cases, with proximal penile and bulboperineal accounting for 23.52% and 21.17% respectively. Significant past surgical history found was suprapubic catheterization in 100%, a failed primary attempt of internal optical urethrotomy (IOU) in 29.41%, multiple recurrences in 48.23%, and re-do urethroplasty in 10.58% of cases. The most common procedure performed was end-to-end anastomotic urethroplasty in 81%, other procedures included penile flap urethroplasty, pull-through procedure, and 10.58% of cases required pubectomy. Urethroplasty was found highly successful in 94% of mean follow-ups 15 months. The cause of failure was wound infection in 1, UTI in 2, and necrosis of penile skin flap in 2 patients. Conclusion: Our initial results conclude that anastomotic urethroplasty is an effective and mainstay treatment modality in the management of urethral stricture disease. It bears less rate of recurrence of urethral stricture. Keywords: Urethroplasty, urethro stricture, Recurrence