EDITORIAL COMMENT

The ideal bulbar urethral stricture management technique has not yet been found. Various treatment methods can be used successfully in bulbar urethral stricture, and surgeons must be comfortable with different procedures, as anatomical pathology can vary intraoperatively. The art of managing urethral stricture disease requires that reconstructive urologists be facile with multiple techniques that can be tailored to each patient. In this article, the study kindly presented the authors’ experience in carrying out two different variations on repair of bulbar urethral stricture. The authors compared the effectiveness of buccal mucosa graft dorsal onlay urethroplasty (BMG) with excision and primary anastomosis. Over 75% of these strictures were of traumatic or iatrogenic etiologies, and none of the patients were redo urethroplasties and none had hypospadias. The authors demonstrated that these techniques can achieve similar functional outcomes, despite the BMG group had longer strictures (5.9 cm vs. <2 cm). Just as importantly, the authors demonstrated a reduced complication rate with BMG. Due to advances in surgical techniques, the success of urethral reconstruction is measured in quality of life, which includes return to normal urinary and sexual function. While the ultimate success of an operation is highly dependent on surgical skill, the authors concluded that BMG may help improve patient outcomes for any length of bulbar stricture needing urethroplasty.