Trauma-induced urethral strictures are more common in primary care and their treatment is one of the more complex problems in urology. The main treatment modalities include: (1) urethral dilatation; (2) endourethrotomy under direct vision; and (3) end-to-end anastomosis of the stenotic segment. Among them, intracavitary surgery with urethral endoscopic cold knife incision plus electrodesiccation for urethral stricture has become the first choice for surgical treatment of urethral stricture because of its low trauma, high success rate, repeatability, and few serious complications such as penile erectile dysfunction. Endourethral cold knife incision is an intracavitary procedure that has been widely used clinically and increasingly refined since Saches first applied endoscopic direct vision endourethrotomy in 1972. Early urethral atresia with a length of less than 2 cm is an indication for cold knife endourethrotomy. Nowadays, with the maturity of technology, as long as the ureteral catheter can pass through the urethral stricture section, urethral atresia without urethral misalignment is an indication for cold knife urethrotomy or combined electrodesiccation for urethral stricture or atresia. The success rate of the 24 cases in this group was 95.5%, and no serious complications occurred in any of the cases. The factors related to the success of the surgery in combination with the literature are: ① The length of the urethral stricture segment: it is generally believed that the longer the stricture distance, the greater the chance of scar healing, and one case of restenosis occurred in this group with 2.5 cm urethral stricture distance. ② Excision of scar tissue: Incomplete removal of scar tissue is the main cause of secondary stenosis, and too deep removal is likely to cause side injury. ③ Correct guidance: A guidewire or catheter must be available for those with urethral stricture. The cold knife entry mark can also be determined during urethral stricture surgery by injecting melanic solution from the bladder and according to the direction of the outflowing fluid. In cases of posterior urethral atresia, a urethral probe should be used to enter the posterior urethra from the fistula opening, and the direction of travel of the activity of the tip of the urethral probe should be observed and felt under direct vision, while the assistant or the operator’s finger enters the anus to indicate the direction of cold knife entry. ④ Duration of urethral stent catheter retention: we believe that adequate healing time should be given to the urethral mucosal trauma, and the specific extraction of the stent catheter is subject to the healing situation. The literature reports that the retention time of stent catheter is positively correlated with urethral healing and efficacy, that is, the longer the retention time, the higher the healing rate and the better the long-term efficacy. However, further discussion is needed in the context of practice. No matter how successful the surgery is, the complication of postoperative scar formation leading to urethral stricture still cannot be completely avoided. Nine patients in our group showed thinning of the urinary stream (37%), and we experienced that regular urethral dilation at the early onset of stricture symptoms to give some support to the urethra and prevent scar stricture was more effective after 3-6 months of early regular dilation. Steenkamp et al. reported that restenosis was most likely to occur 6 months after urethral stricture, while recurrence decreased significantly after 1 year. In this group of patients, the urethral dilatation must be performed according to the different segments of the stricture, and the urethra of the patient must be clearly understood, and the direction of the head of the urethral probe should be carefully understood, and the urethra should be entered according to the trend, so that the slight bleeding of the urethra will be stopped. Do not roughly expand, aggravate the urethral injury and cause re-scarring stenosis. Therefore, urethral dilation after endourethrotomy is necessary according to different conditions. For patients with more complex urethral strictures, postoperative urethral dilation is best performed by the operator himself to improve the success rate of dilation and to prevent the creation of a medically induced false tract. In conclusion, trauma to the urethra due to work-related injuries, accidents, etc. is mostly seen in primary care hospitals. The treatment of urethral strictures by direct vision endourethrotomy requires only the commonly used endourethroscope, which has the advantage of simple equipment and easy implementation, and more importantly, the success rate of the operation is not lower than other treatment modalities, and it is performed under direct vision, which has the advantages of less damage, less medically induced re-injury, repeatable application, etc. Moreover, the indications are wide, and it is applicable to many types of urethral strictures, and those who can still urinate or even dribble can be tried to insert Once the catheter is successfully passed through the stenosis, an endourethral incision can be sought, making the clinical problem simple and easy to handle.