A urethral stricture is a scar from tissue injury after local trauma, inflammation, or infection. External trauma and iatrogenic
injuries are now main aetiological factors in majority of anterior urethral strictures, although in many cases the
aetiology is unknown and is reported as idiopathic. The prevalence of urethral stricture is estimated in the range from
1 to 9 strictures per 1,000 people(1). The open surgical repair of urethral strictures has dramatically changed. Nearly all
urethral strictures can be reconstructed in a one stage operation, only a small proportion of patients, who have severely
scarred or insufficient local tissues, associated skin infections, or complex strictures, fistulas, require a multistage approach.
Management of urethral strictures should not be performed following a certain scale of possible interventions.
The practice of repeated dilatations and urethrotomy before considering urethroplasty should be abandoned. Some authors
suggest that endoscopic treatment of urethral strictures using dilatation or urethrotomy exacerbates scar formation,
thus adding length and severity to the stricture, complicating subsequent open repair. These authors suggest that
urethrotomy and dilatation is over estimated in treatment of strictures(1). Urethroplasty should not be primarily contraindicated
based on age. Elderly men tolerate urethroplasty well, with similarly low complication rate as in younger
men(1). In 1993, for the first time, El Kasaby reported that the oral mucosal graft from the lip was used for treatment of
penile and bulbar urethral strictures in adult patients. Since then, oral mucosa has become an increasingly popular graft
tissue for penile or bulbar urethral reconstruction performed in single or multiple stages. Oral mucosa graft is hairless,
has a thick elastin-rich epithelium which makes it tough easy to handle, and has a thin and highly vascular lamina propria
which facilitates inosculation and imbibition.