Difficulty in urination is the main symptom of urethral stricture, which can be severe with increased residual urine volume and urinary retention. Treatment can be either surgical or non-surgical. The first reaction of most patients when they hear that they have to go under the knife is more or less resistance, because after all, surgery has risks and caution is needed. Today, we will talk about the treatment of urethral stricture. Know your enemy and know yourself so that you can fight a hundred battles! Non-surgical treatment Urethral dilatation is a common non-surgical treatment. However, it should not be performed when there is acute inflammation of the urethra. The dilation must be done gradually with a small probe rod in increasing order of size. The patient may feel painful and distended during the dilation process. After each urethral dilation, the urethra becomes congested and edematous, and it takes about 2 to 3 days to subside, so it is not advisable to perform consecutive dilation within 4 days. The interval between the second dilation usually starts from about 1 week and is gradually extended. Transurethral injection of urethral irrigation fluid can prevent reoccurrence of urethral stricture and provide a soft dilatation effect. Physiotherapy methods such as audio and iodine penetration can accelerate scar softening and consolidate the effect of dilation. Even after surgical treatment cases should be dilated regularly to prevent re-stenosis. Surgical treatment There are many surgical treatment options, the choice of which depends on the experience of the surgeon, the condition of the patient’s stricture and the medical conditions available at the local hospital. 1. Urethrotomy is suitable for cases of stenosis of the external urethra. It can be performed by making a longitudinal incision on the ventral side of the external urethra to form a mild hypospadias, and suturing the mucosa of the urethra on both sides of the incision with the skin of the head of the penis to stop bleeding. If the urethral stricture is very short in length or even a membranous stricture, the stricture ring can be cut with a special cold knife under direct urethroscopic view. The incision can be performed with a fine ureteral catheter inserted as a guide. If necessary, the excess scar tissue can then be removed with an electric knife. 3.Urethral stricture segment excision and reanastomosis In cases where internal incision is not possible, a suitable incision should be selected to excise the stricture segment urethra and its surrounding scar tissue under good exposure, and the catheter should be retained for about 2-3 weeks after surgery. 4.Stenosis segment urethrotomy Suitable for penile segment urethral strictures or longer urethral strictures that are difficult to repair in one stage. 5.Urethroplasty The defective urethra can be used with own bladder mucosa, tipped bladder flap. Urethroplasty can be repaired with a tipped flap/ or medium-thickness skin flap. 6.Urethral diversion Urethral stricture surgery in general requires simultaneous cystostomy to drain the urine. In exceptional patients, the cystostomy may be maintained pending reoperation or as a permanent treatment. Caution: Urethral stricture surgery is a more difficult procedure. It must be adequately prepared before surgery, the surgical plan must be designed exactly for the patient’s own situation, and must be regularly dilated with prevention to achieve good results. Postoperative reoccurrence of stricture, urinary fistula formation, Yang thinning and urinary incontinence are also more common complications. Therefore, patients should not be in a hurry to seek medical help!