Current approaches to male anterior urethral reconstruction: what we do and why?

The management of male anterior urethral strictures is complex and continues to evolve. Due to high success rates and low morbidity, open reconstruction has become the preferred primary treatment modality over repeated minimally invasive options. Urethroplasty describes this diverse group of open reconstructive techniques applied to a heterogenous disease process. As controlled trials are scarce, a comparison of different techniques across varied circumstances is difficult. Furthermore, long-term success is also dependent upon patient comorbidities. Ultimately, accurate determination of the stricture length, location, and etiology is imperative for procedure selection. Therefore, we describe our approach and rationale behind the evaluation and treatment planning of patients with anterior urethral strictures, addressing current controversies and proposing future directions of research.