Reconstructive surgery of distal urethral strictures: Techniques and sexual complications [La chirurgia ricostruttiva nelle stenosi uretrali anteriori: Tecniche e complicanze sessuali]

The etio-pathological differences of the strictures and the various reconstructive concepts depend on the different structure of the penile and bulbar urethra. The study of the urethral strictures by new information of surgical anatomy-etiology-physiopathology and diagnosis have determined some important innovations concerning genito-urethral reconstructive surgery: a) the dorsal or ventral urethral augmentation, when the urethral plate can be preserved; b) the two-stage urethral reconstruction, when the urethral plate is not available; c) the cosmetic reconstruction of the glans penis and of the urethral meatus. In the modern era succesful urethral reconstructions has to guarantee not only the urinary function but also of sexual activity and the cosmetic aspect of the genitalia. The new trend of genito-urethral surgery focuses on less aggressive techniques less aggressive and reducing the risk of patient dissatisfaction. Thus, success outcome in urethral repair should be stated not only by objective voiding parameters but also by subjective parameters influencing patient satisfaction and these latter must be considered in the treatment choice.