J Reconstr Microsurg 2011; 27(3): 179-186
DOI: 10.1055/s-0030-1270535
© Thieme Medical Publishers

Review of Microsurgical Posterior Urethral Reconstruction

Amanda K. Nelson1 , Hunter Wessells2 , Jeffrey B. Friedrich1 , 2
  • 1Division of Plastic Surgery, University of Washington, Seattle, Washington
  • 2Department of Urology, University of Washington, Seattle, Washington
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23. Dezember 2010 (online)


Posterior urethra reconstruction can be a challenging proposition for both patient and surgeon. The vast majority of urethras can be successfully reconstructed with either anastomosis or grafting. However, there are some patients who have recurrent urethral strictures that require more complex reconstruction. There is some speculation that microsurgical penile revascularization may allow subsequent graft reconstruction with lower stricture rates, but this is not yet proven. For the most tenacious urethral strictures, free tissue transfer may be required. The free radial forearm flap is well suited for urethral reconstruction, and the free anterolateral thigh flap may also have a role for these patients. This article will review urethral trauma and strictures and microsurgery’s role in reconstruction of the posterior urethra.


Jeffrey Friedrich, M.D. 

325 9th Avenue, Box 359796

Seattle, WA 98104

eMail: jfriedri@uw.edu