Urol. praxi. 2026;27(3):128-138 | DOI: 10.36290/uro.2026.026

Surgical treatment of anterior urethral strictures in males

MUDr. Jaroslav Ženíšek, Ph.D.
Urologické oddělení Nemocnice Jihlava, p. o.

Surgical treatment of urethral stricture is a dominant category in reconstructive urology requiring a comprehensive understanding of the range of available surgical techniques. No single technique is sufficient to address all cases. The results of the reconstruction must meet demanding functional criteria, as well as aesthetic requirements, especially when solving penile urethral strictures. It is important to master complex decision-making using known algorithms and select appropriate interventions, and choose the correct approach while taking potential complications in the future into account.

Keywords: urethral stricture, urethroplasty, surgical technique.

Accepted: September 15, 2026; Published: October 21, 2026  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Ženíšek J. Surgical treatment of anterior urethral strictures in males. Urol. praxi. 2026;27(3):128-138. doi: 10.36290/uro.2026.026.
Download citation

References

  1. Markiewicz MR, Margarone JE III, Barbagli G, et al. Oral Mucosa Harvest: An Overview of Anatomic and Biologic Considerations. EAU-EBU Update Series. 2007;5(5):179-187. Go to original source...
  2. Duckett JW, Coplen D, Ewalt D, et al. Buccal mucosal urethral replacement. J Urol. 1995 May;153(5):1660-3. PMID: 7715003. Go to original source...
  3. Rudney JD, Chen R. The vital status of human buccal epithelial cells and the bacteria associated with them. Arch Oral Biol. 2006 Apr;51(4):291-8. doi: 10.1016/j.archoralbio.2005.09.003. Epub 2005 Oct 18. PMID: 16239000. Go to original source...
  4. Simonato A, Gregori A, Ambruosi C, et al. Lingual mucosal graft urethroplasty for anterior urethral reconstruction. Eur Urol. 2008 Jul;54(1):79-85. doi: 10.1016/j.eururo.2008.01.023. Epub 2008 Jan 16. PMID: 18261844. Go to original source...
  5. Wang A, Chua M, Talla V, et al. Lingual versus buccal mucosal graft for augmentation urethroplasty: a meta-analysis of surgical outcomes and patient-reported donor site morbidity. Int Urol Nephrol. 2021 May;53(5):907-918. doi: 10.1007/s11255-020-02720-7. Epub 2021 Jan 7. PMID: 33415488. Go to original source...
  6. Barbagli G, Balò S, Sansalone S, et al. How to harvest buccal mucosa from the cheek. Afr J Urol. 2015;22(10):1016/j.afju.2015.09.001. Go to original source...
  7. Rourke K, McKinny S, St Martin B. Effect of wound closure on buccal mucosal graft harvest site morbidity: results of a randomized prospective trial. Urology. 2012 Feb;79(2):443-7. doi: 10.1016/j.urology.2011.08.073. Epub 2011 Nov 25. PMID: 22119261. Go to original source...
  8. Zimmerman WB, Santucci RA. Buccal mucosa urethroplasty for adult urethral strictures. Indian J Urol. 2011 Jul;27(3):364-70. doi: 10.4103/0970-1591.85441. PMID: 22022061; PMCID: PMC3193738. Go to original source... Go to PubMed...
  9. Barbagli G, Fossati N, Sansalone S, et al. Prediction of early and late complications after oral mucosal graft harvesting: multivariable analysis from a cohort of 553 consecutive patients. J Urol. 2014 Mar;191(3):688-93. doi: 10.1016/j.juro.2013.09.006. Epub 2013 Sep 11. PMID: 24035880. Go to original source...
  10. Wessells H, Morey A, Vanni A, et al. Urethral stricture disease guideline amendment. J Urol. 2023;210(1):64-71. Go to original source...
  11. Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol. 1999 May;161(5):1535-40. PMID: 10210391. Go to original source...
  12. Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000;19(5):553-64. doi: 10.1002/1520-6777(2000)19:53.0.co;2-b. PMID: 11002298. Go to original source...
  13. Purohit RS, Golan R, Copeli F, Weinberger J, Benedon M, Mekel G, Blaivas JG. Natural History of Low-stage Urethral Strictures. Urology. 2017 Oct;108:180-183. doi: 10.1016/j.urology.2017.05.025. Epub 2017 May 25. PMID: 28552818. Go to original source...
  14. Santucci RA, Mario LA, McAninch JW. Anastomotic urethroplasty for bulbar urethral stricture: analysis of 168 patients. J Urol. 2002 Apr;167(4):1715-9. PMID: 11912394. Go to original source...
  15. Substitution urethroplasty is as successful as anastomotic urethroplasty for short bulbar strictures - PubMedn.d.https://pubmed.ncbi.nlm.nih.gov/25483766/.Accssed 28 Dec 2023.
  16. Andrich DE, Mundy AR. Non-transecting anastomotic bulbar urethroplasty: a preliminary report. BJU International. 2012;109(7):1090. doi. 10.1111/j.1464-410X.2011.10508.x. Go to original source...
  17. Bugeja S, Ivaz S, Frost AV, et al. Mundy Non-transecting bulbar urethroplasty using buccal mucosa. Afr J Urol. 2016;22:47-53. Go to original source...
  18. Jordan GH, Eltahawy EA, Virasoro R. The technique of vessel sparing excision and primary anastomosis for proximal bulbous urethral reconstruction. J Urol. 2007 May;177(5):1799-802. Go to original source...
  19. Kunz I, Musch M, Vogel A, et al. Experience with One-Stage Repair of Urethral Strictures Using the Augmented Anastomotic Repair Technique. Urol Int. 2018;100(4):386-396. doi: 10.1159/000481267. Epub 2018 May 2. PMID: 29719299. Go to original source...
  20. Barbagli G, Palminteri E, Guazzoni G, et al. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique? J Urol. 2005 Sep;174(3):955-7; discussion 957-8. Go to original source...
  21. Sharma P, Sharma K, Goel A. De novo erectile dysfunction after anterior urethroplasty: a systematic review and meta-analysis. BJU International. 2013;112(4):E425. https://doi.org/10.1111/bju.12362_3 Go to original source...
  22. Mitra D, Bansal V K, Sharma D. Evaluation of Erectile Dysfunction as a Consequence of Urethroplasty: A Prospective Observational Study. Cureus. 2025,17(5):e84936. doi: 10.7759/cureus.84936. Go to original source...
  23. Ahyai SA, Schmid M, Kuhl M, et al. Outcomes of Ventral Onlay Buccal Mucosa Graft Urethroplasty in Patients after Radiotherapy. Journal of Urology [Internet]. 2015 Aug 1 [cited 2026 May 1];194(2):441-6. Go to original source...
  24. Hofer MD, Zhao LC, Morey AF, et al. Outcomes after Urethroplasty for Radiotherapy Induced Bulbomembranous Urethral Stricture Disease. Journal of Urology [Internet]. [cited 2026 May 1]. 2014 May 1;191(5):1307-12. Go to original source...
  25. Barbagli G, Balò S, Sansalone S, et al. Dorsal onlay graft bulbar urethroplasty using buccal mucosa. Afr J Urol. 2016;22(1):5-10. Go to original source...
  26. Kulkarni S, Barbagli G, Sansalone S, et al. One-sided anterior urethroplasty: a new dorsal onlay graft technique. BJU Int. 2009 Oct;104(8):1150-5. doi: 10.1111/j.1464-410X.2009.08590.x. Epub 2009 Apr 17. PMID: 19388990. Go to original source... Go to PubMed...
  27. Joshi P, Bandini M, Kulkarni SB. Mucosal-sparing augmented non-transected anastomotic (MsANTA) urethroplasty: a step forward in ANTA urethroplasty. BJU Int. 2022;130: 133-136. Go to original source...
  28. Bandini M, Joshi P, Bafna S, et al. Establishing the role of single-stage preputial spiral graft urethroplasty for panurethral stricture. BJU Int. 2025 Oct;136(4):640-646. Go to original source...
  29. Hillary CJ, Osman NI, Chapple CR. Current trends in urethral stricture management. Asian J Urol. 2014 Oct;1(1):46-54. Go to original source...
  30. Jordan GH. Reconstruction of the fossa navicularis. J. Urol. 1987;138:102-4. Go to original source...
  31. Fiala R, Vrtal R, Zenisek J, et al. Ventral prepucial flap meatoplasty in the treatment of distal urethral male strictures. Eur Urol. 2003 Jun;43(6):686-8. Go to original source...
  32. Nikolavsky D, Abouelleil M, Daneshvar M. Transurethral ventral buccal mucosa graft inlay urethroplasty for reconstruction of fossa navicularis and distal urethral strictures: surgical technique and preliminary results. Int Urol Nephrol. 2016 Nov;48(11):1823-1829. Go to original source...
  33. Daneshvar M, Simhan J, Blakely S, et al. Transurethral ventral buccal mucosa graft inlay for treatment of distal urethral strictures: international multi-institutional experience. World J Urol. 2020 Oct;38(10):2601-2607. Go to original source...
  34. Asopa HS, Garg M, Singhal GG, et al. Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach. Urology. 2001;58:657-9. Go to original source...
  35. Barbagli G, Balo S, Sansalone S, et al. Dorsal onlay graft bulbar urethroplasty using buccal mucosa. Afr J Urol. 2016;22(1):5-10. Go to original source...
  36. 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. Go to original source...
  37. Marshall SD, Raup VT, Brandes SD, Dorsal inlay buccal mucosal graft (Asopa) urethroplasty for anterior urethral stricture. Transl Androl Urol. 2015;4(1):10-15.
  38. Pisapati VL, Paturi S, Bethu S, et al. Dorsal buccal mucosal graft urethroplasty for anterior urethral stricture by Asopa technique. Eur Urol. 2009;56:201-5. Go to original source...
  39. Aldaqadossi H, El Gamal S, El-Nadey M, et al. Dorsal onlay (Barbagli technique) versus dorsal inlay (Asopa technique) buccal mucosal graft urethroplasty for anterior urethral stricture: a prospective randomized study. Int J Urol. 2014;21:185-8. Go to original source...
  40. Schreiter F, Noll F. Mesh graft urethroplasty using split thickness skin graft or foreskin. J Urol. 1989 Nov;142(5):1223-6. doi: 10.1016/s0022-5347(17)39036-5. PMID: 2810499. Go to original source...
  41. Ram-Liebig G, Barbagli G, Heidenreich A, et al. Results of use of tissue-engineered autologous oral mucosa graft for urethral reconstruction: a multicenter, prospective, observational trial. EBioMedicine. 2017;23:185-192. Go to original source...
  42. Johanson B. Reconstruction of the male urethra and strictures. Acta Chir Scand. 1953;176:3-88.
  43. Blandy JP, Singh M, Tresidder GC. Urethroplasty by scrotal flap for long urethral strictures. Br J Urol. 1968; 40(3):261-7. Go to original source...
  44. Barbagli G, Angelis AM, Romano G, et al. Clinical outcome and quality of live assessment in patient treated with perineal urethrostomy for anteriorurethral stricture disease J Urol. 2009;(2):548-57. Go to original source...




Urology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.