Internal Urethrotomy
Internal urethrotomy is performed in the operating room using an endoscope, a slim instrument through which a physician can view internal structures or perform procedures. Through the endoscope, an incision is made in the stricture to "open it." Then a catheter is inserted to hold the urethra open.

Management afterward may include intermittent self-catheterization to maintain the opening of the stricture. In self-catheterization, an individual inserts a catheter into his urethra periodically to prevent stricture from recurring.

Urethral Stent Placement
Urethral stenting is the surgical placement of a short tube into the urethra. The stent is placed endoscopically and holds the strictured portion of the urethra open as it heals after surgery (preventing the normal scar formation of healing from causing the stricture to recur). The lining of the urethra eventually covers the stent, and it remains in place permanently.

Open Urethral Reconstruction
Open reconstruction of urethral stricture disease may involve anastomosis or a tissue transfer. In anastomosis surgery, the strictured segment is removed, and the two ends are reconnected. This procedure is best suited for short strictures involving the bulbar urethra.

When this repair is not possible, tissue can be transferred to enlarge the strictured segment. Tissue may be transferred from another part of the penis or from elsewhere on the body. An alternative to these procedures is a two-stage repair in which a skin graft is placed along the undersurface of the penis and later rolled into a new urethra.

The choice of repair is individual and influenced by the length and location of the stricture, the availability of local tissue, and other factors.