Dorsal Circumcision Approach for Penile Strictures

The penile urethral stricture is an heterogeneous entity with a wide variety of etiologies including post-infectious, catheter-induced, lichen sclerosus, failed hypospadias, and idiopathic causes [1, 2]. Penile urethral strictures can be classified as either simple or complex. The majority are simple strictures, which can be addressed in a one-stage procedure. However, complex strictures may require a staged approach to achieve a higher success rate [2, 3]. Complex strictures include redo cases, failed hypospadias, poor tissue quality, scarred urethral plate, lichen sclerosus, or fistula [2]. Internal urethrotomy is not recommended due to the risk of chordee and recurrence [4]. Various techniques, such as flap or graft urethroplasties, are the surgical techniques of choice. In this chapter, we aim to describe the treatment of short distal strictures with Kulkarni one-sided technique, with a success rate of 85–90%.