Joshi's Step With Buccal Mucosal Graft Urethroplasty in Nearly Obliterated Bulbar Urethral Stricture

Urethroplasty is a rapidly evolving art that continually improves and reinvents itself. After a century of silence, during which the anastomotic repair was the only solution for approaching the strictured urethra, the 1990s can be considered the Renaissance period for reconstructive urology.

In 2022, Joshi and Kulkarni introduced a new step to the augmented urethroplasty, particularly in patients with extremely narrow strictures where a single augmentation was insufficient. They avoid any resection of the residual native urethral plate, marking the narrowest portion. Then, the edges of the mucosa are reapproximated with interrupted suturing in a proper non-resecting approach.

Inclusion criteria

• Patients with primary bulbar urethral stricture.
• Patients with non-traumatic bulbar urethral stricture.
• Patients with nearly obliterated bulbar urethral stricture, with the narrowest portion of the stricture is less than 1.5 cm in length.

Exclusion criteria

• Patients with traumatic bulbar urethral stricture.
• Patients with redo bulbar urethral stricture.
• Patients with obliterated bulbar urethral stricture.
• Patients with nearly obliterated long bulbar urethral stricture.