History of urethral surgery: Lessons learnt from the past

Actas Urol Esp (Engl Ed). 2024 Dec 19:S2173-5786(24)00129-X. doi: 10.1016/j.acuroe.2024.12.003. Online ahead of print.
[Article in English, Spanish]

Abstract

Introduction: Although failures are undesirable, they offer valuable learning opportunities that drive progress through necessary changes. This concept holds particularly true in the history of urethral reconstruction.

Methods: A comprehensive literature review was conducted using PubMed, focusing on the history of the urethral stricture and current trends based on national and international guidelines for urethral stricture management.

Results: Urethral strictures are among the oldest known urological conditions, with initial treatments centred around dilatation. These palliative measures proved disappointing. The advent of reconstructive urology has transformed this pathology into a treatable condition, notably through Excision and Primary Anastomosis (EPA) and one-stage augmentation urethroplasty using buccal grafts.

Conclusion: Urethroplasty is the gold standard treatment for urethral strictures, and ongoing refinements aim to further reduce morbidity.

Keywords: Buccal grafts; Dilatación; Dilatation; Escisión y anastomosis primaria (EAP); Estenosis uretral; Excision and primary anastomosis (EPA); Injertos bucales; Reconstrucción uretral; Reconstructive urology; Urethral reconstruction; Urethral stricture; Urethroplasty; Uretroplastia; Urología reconstructiva.

Publication types

  • Review