Urethral strictures have long been managed by choosing the simplest treatment first, and only if this was not successful was a more complex or more difficult procedure chosen. Internal urethrotomy or repeated attempts at urethro-tomy were performed, before an open surgical procedure was considered. However, long-term functional and cosmetic results rather than the simplicity of the procedure should govern the choice of therapy.

™ Internal urethrotomy has a place in the treatment of strictures. It can be curative for strictures involving epithelium alone or those involving superficial spongiofibrosis (O Fig. 2.1A-C). ™ The indication for endoscopic treatment depends on the position and length of the stricture. The best results are obtained with ure-throtomy for meatal stenosis and for simple and short bulbar urethral strictures.

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