The Joshi Step

One of the key principles of urethral reconstruction includes preserving the vascularity of healthy tissue to facilitate healing, optimize the integrity of the repair, and minimize ischemic insult leading to scarring. Mucosal-sparing augmented non-transected anastomotic urethroplasty, also known as the Joshi step, is a technique used to widen the native urethral plate at its narrowest point without transecting it, allowing for maximal preservation of the tissue blood supply.