I. Urethral Dilation Urethral dilation is the most primitive method of treating urethral strictures, and was used by Egyptian and Indian physicians as early as the 6th century BC. For strictures caused by superficial scars or folds in the urethral mucosa, dilation is a preferable method that results in enlargement of the urethral lumen without creating new scars. However, the vast majority of dilation is a method of temporary management rather than a means of cure. We must realize that if dilation causes bleeding, there must be tissue damage, and that means new scars will form. Urethral strictures in adults tend to start at less than 18F and most patients do not dilate beyond 20-22F. Endourethrotomy Endourethrotomy is limited to mucosal fold-like strictures and to patients with very superficial cavernous fibrosis or strictures shorter than 1 cm. The principle of endourethrotomy is to cut through the stricture so that the soft elastic tissue can expand into the urethra. To be effective, the incision must be deep to the full extent of the cavernous fibrosis. It takes 4-6 weeks for the urethral epithelium to grow halfway around the urethra and therefore 4-6 weeks for the catheter to be left in place in patients with internal urethrotomy. Epithelialization is facilitated after endourethrotomy of superficial strictures. 3. Urethral repair and reconstruction 1. end-to-end anastomosis of the stenotic segment resected urethra Stenosis segmental resection urethral anastomosis is limited to short length urethral strictures (1~2 cm). 2.Urethral reconstruction with tipped flap graft. 3. Free mucosa reconstruction of the urethra. The mucosal tissues used for repair and reconstruction of urethra are bladder mucosa, oral mucosa, colonic mucosa, etc. Recently, tongue mucosa has been used more and more.