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Distal penile circular fasciocutaneous flap for complex anterior urethral strictures

Complex anterior urethral strictures represent challenging cases even for the experienced reconstructive urologist. Urethral trauma is the most common reported cause ( ≈ 50%) with the remainder being idiopathic. Risk factors are long-term urethral catheterization, previous urethral instrumentation, unrecognised urethral trauma, chronic urethritis, and compromised urethral blood flow. Scar excision and anastomotic urethroplasty is reserved for short bulbar urethral strictures ( < 2.0–2.2 cm) due to the risk of penile shortening and tissue ischaemia with more extensive resections [1].