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Djordjevic et al. Plast Aesthet Res 2023;10:4 https://dx.doi.org/10.20517/2347-9264.2023.09 Page 3 of 4

A completely different issue is post-radiation urethral stricture, which occurs in more than 30%. Its
management presents a challenge for reconstructive urologists and remains a challenge for patients who
desire improvement of quality of life by avoiding permanent urethral or suprapubic catheterization. In the
Guerass review entitled “Post irradiation urethral stricture”, all aspects of this critical problem are discussed;
the authors conclude that the treatment should be performed by experienced reconstructive surgeons adept
at using different grafts or flaps as treatment options. To avoid management failure, particular attention
should be taken to understanding the characteristics of irradiated tissues.

Even though female urethral stricture is rare, several publications suggest a heightened interest in the
reconstructive urology community. DeLong et al. reviewed etiology and different therapeutic options
according to the guidelines of leading urological societies. Their management ranges from simple non-
surgical to complex reconstructive procedures. The authors reported all surgical options, advantages, and
disadvantages and recommended new protocols. In “Female urethral stricture: techniques for
reconstruction”, they concluded that technology such as tissue engineering could improve the treatment of
this challenging problem.

The exciting “nature” of urethral stricture disease suggests the need for the creative combination of various
techniques and strategies, often involving tissue transfer procedures, either as grafts or as flaps, to achieve
successful outcomes. Various tissues such as oral mucosa, genital or extragenital skin, and bowel and
bladder mucosa have been used for urethroplasty. In cases of preserved and healthy penile skin, genital skin
flaps present another option for achieving a successful outcome. Finally, tissue-engineered substitutes for
the human urethra present a new frontier.

Finally, based on the established principles of reconstruction, as we push forward in this challenging art, we
need to adapt to growing demands for publishing new techniques, modifications, long-term results, and
future challenges.

DECLARATIONS
Authors’ contributions
Made substantial contributions to the conception and design of the study and performed data analysis and
interpretation: Djordjevic ML, Purohit RS
Performed data acquisition and provided administrative and technical support: Djordjevic ML, Purohit RS

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.