Surgical practice for complex urethral stricture: evolution of materials,techniques,and concepts
10.12483/j.issn.1009-8291.2026.02.002
- VernacularTitle:复杂性尿道狭窄的外科实践：材料、术式与理念的变迁
- Author:
Lujie SONG
1
;
Tianzheng HAO
1
Author Information
1. Department of Urology, Medical School of Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Eastern Urological Reconstruction and Repair Institute, Shanghai 200233, China
- Publication Type:Journal Article
- Keywords:
urethral stricture;
urethroplasty;
flaps;
oral mucosa;
non-transecting anastomosis;
tissue engineering
- From:
Journal of Modern Urology
2026;31(2):109-113
- CountryChina
- Language:Chinese
-
Abstract:
Urethral stricture is a common and complex disease in urology, which seriously affects the quality of life of patients and poses challenges to clinical treatment. Urethral reconstructive surgery has evolved from palliative approaches such as dilation and internal urethrotomy to systematic reconstruction based on flaps and mucosal grafts. With the introduction of oral mucosa and its histological compatibility, autologous mucosa has become the mainstay urethral substitute, while flaps remain indispensable in extensive and complex cases due to their robust vascularity. Advances in various fields of study have had a significant impact on the philosophy of surgery. The new approach has placed a higher value on anatomical structure and functional preservation alongside patency rates. This shift in focus has led to an increased importance of non-discontinuous anastomosis. Particularly in the repair of urethral injuries following pelvic fractures, Chinese scholars have utilized extensive case series to pioneer innovations in pediatric cases, complex obstructions, and combined fistula repair, thereby enriching global expertise. Concurrently, there is a growing interest in the exploration of tissue engineering and novel biomaterials for urethral repair. These approaches, ranging from the submucosal matrix of the small intestine to biomimetic degradable scaffolds, cellloaded engineered mucosa, and 3D-printed materials, are progressively entering clinical validation phases. In summary, urethral reconstruction is undergoing a shift from “reconstructing anatomy” to “balancing function.” Driven by precision medicine and regenerative medicine, it is expected to achieve more optimal individualized treatments in the future.
