Background: To show our experience with the staged Johanson’s urethroplasty as a salvage treatment of difficult and complicated groups of patients, and to present the total urethroplasty technique. Material and Methods: During a 12–year period, 68 men with urethral stricture underwent the staged Johanson’s urethroplasty. 51 had war–related injuries (75%) resulting in an unhealthy perineal and genital skin with fistulae and/or scarring. 35 patients (52%) had other urethral or vesical problems. 60 patients (88%) had long (0.5–4 cm), multiple or impassable strictures. 58 patients (85%) had strictures of the pendulous urethra. The second stage was performed 2–3 months after the first. Both stages of Johanson’s urethroplasty were protected by a stab suprapubic catheter for 3 weeks. Patients were followed up for 23–82 months (mean 52.5). Results: All patients but 4 had improved urine flow (best Qmax ranged between 13.2 and 31.8 ml/s; mean 17.4). 4 patients (6%) needed a revision because of fistula formation or recurrence and 6 patients (9%) developed urinary tract infection postoperatively. Conclusions: The staged Johanson’s urethroplasty is a good treatment for the difficult and complicated urethral strictures which are not suitable for optical urethrotomy, especially those in the pendulous part. In strictures involving all parts of the urethra total urethroplasty could be performed.

Turner–Warwick R: The principles of functional reconstruction of the lower urinary tract; in Beran PJ (ed): Reconstructive Procedures in Surgery. Oxford, Blackwell Scientific Publication, 1982, pp 193–233.
Turner–Warwick R: Urethral stricture surgery; in Glenn J, Boyce G (eds): Urologic Surgery, ed 3. Philadelphia, Lippincott, 1983, pp 689– 719.
Turner–Warwick R: The repair of urethral strictures in the region of the membranous urethra. J Urol 1968;100:303.
Johanson B: Reconstruction of the male urethra in strictures. Acta Chir Scand 1953;179 (suppl):19.
Al–Ali M, Al–Shukry M: Endoscopic repair in 154 cases of urethral occlusion: The promise of guided optical urethral reconstruction. J Urol 1997;157:129.
Devine CJ JR: Surgery of the urethra; in Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds): Campbell’s Urology, ed 7. Philadelphia, Saunders, 1998, vol 3, pp 2853–2886.
Webster GD, Khoury JM: Urethral stricture disease; in Krane RJ, Fitzpatrick JM (eds): Clinical Urology. Philadelphia Lippincott, 1994, pp 906–924.
Al–Ali M, Kashmoula D, Saoud I: Experience with 30 posttraumatic rectourethral fistulas: Presentation of posterior transsphincteric anterior rectal wall advancement. J Urol 1997;158: 421–424.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.