Approach to Redo Surgery for Failed TIP Urethroplasty

Urethroplasty reinterventions are complicated procedures that should only be performed by surgeons with extensive experience in this type of surgery. The success of these surgeries depends not only on the surgeon’s experience but also on many other factors. A meticulous evaluation of the skin and its vascularization as well as the quality of the urethral plate after failed attempts for urethral repair are very important factors that we must consider when considering the type of urethroplasty we should perform. When the urethral plate is narrowed and scarred and there is redundant skin on the penile shaft after the original repair, a vascularized flap may be a good option for urethroplasty. If the urethral plate is unavailable, a buccal mucosa graft and a two-stage urethroplasty would be the best choice.