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So you have been referred to a specialist at Manchester Urology because you have a urethral stricture. Now what that means is you have a narrowing of your waterpipe. For the majority of people the first thing they ask is why have I got it? The commonest reason is what we call idiopathic in that we don’t know and it is just one of those things that happens. From our point of view it is important to establish if this is a first presentation ie you have never had any problems before or if it is a recurrence. If it is a first presentation then it is often dealt with quite straightforwardly, what we call endoscopically ie down the penis so we put the telescope down, we then make a cut into the stricture called a urethrotomy and then place a catheter which stays in for just about 1 week. If however you have a recurrence of a stricture then its often better to talk about a urethroplasty. Urethroplasty takes many different forms but the two most standard types of urethroplasty are fore recurrences of the stricture in the waterpipe or urethra, and it depends on the length and position of the stricture as to whether we can simply excise that small area of narrowing and join the 2 ends together and that is called an anastomotic urethroplasty. But if the stricture is longer or in the penile urethra then often you need an augmentation urethroplasty. The terminology augmentation just means addition of a piece of material. What we do is we use the graft from the inside of the mouth buccal mucosal graft. Why do we use that? Well we use that because that area is used to being wet and therefore it has a very good success rate when used in the urethra. The reason we put people through the larger reconstructive procedures is because they have a very good success rate and long term outcome.