Future directions in urethroplasty: emphasising mucosal preservation and reducing graft dependency

Abstract

We were highly intrigued by the article on mucomucosal anastomotic non-transecting augmentation (MANTA) urethroplasty [1]. The authors' introduced a novel approach to widen the narrowest part of a bulbar stricture while performing an augmentation urethroplasty. For many years, we have firmly believed that non-transecting approaches are transformative in urethroplasty, as they preserve vessels and nerves, thus minimising sexual and functional complications. Reconstructive techniques often involve using double-faced buccal mucosal grafts (BMGs) [2], but this method comes with a higher number of sutures and inherent risk of failure. Consequently, when possible, we advocate for mucosal reconstruction without the use of the second graft for the native urethral plate.