Reconstructive Urology dept. of Shahid Beheshti University of Medical Sciences, located in Shohada-e-Tajrish Hospital, from 24 years ago, was the national reference of country for referring patients with Urethroplasty from all over the country, surrounding nations and European countries. Severe and complicated patients or patients who have previously experience failure in unsuccessful surgery have been referred to this department and Successful surgeries are performed on them according to the international standards. 

Furthermore, during the past 11 years, the department has been developing the Reconstructive Urology fellowships among the Urologists Until now Urologists from the universities of Mashhad, Ahvaz, Tabriz and Shiraz have been graduated from this department with the degree of Fellowship.In addition, urologists from the cities of Isfahan and Mashhad have been trained in this department for a short period of time. 

The Royal Hallamshire Hospital is situated a mile from the city on the Trust's central campus. Nearly 6,000 staff work at the Royal Hallamshire in a wide variety of clinical and non-clinical roles.

The hospital has around 850 beds for the care of inpatients and a number of specialist outpatient clinics including a prosthetic eye department and specialist ophthalmology centre.

The National Defense Medical College Hospital was established on April 18, 1978 with a partial revision of "Cabinet Office Ordinance on Organization of Defense Medical University School" (Prime Minister's Ordinance No. 65 of 1954), and on December 1 of the same year I was opened. 
Initial opening was organized with nine central departments, such as Division 1, Second Department of Internal Medicine, Surgery, Psychiatry, Pediatrics, Obstetrics and Gynecology, etc. 12 departments and departments, the Inspection Department, the Operating Department, the Nursing Department, etc., 200 beds We started as a general hospital with. 
Since then, it has played a role as a clinical education and research center for medicine as well as as a comprehensive medical institution widely open to the local residents at the same time, and it also responds to medical and clinical technologies that are changing more and more constantly We endeavored to expand and expand our education and research fields and to develop a medical care system for outpatient and inpatients who are increasing year by year. In February 1997 we launched a special function hospital, in August 2007 a disaster hospital, in 2008 In Saitama DMAT designated hospital in August and as a cancer clinic designated hospital in April, Heisei 24, respectively, it has reached the present, 15 departments and 15 departments and rooms to be placed as a central medical facility and 800 beds We conduct medical treatment, clinical education and research as a specific functional hospital with the aim. 
The number of outpatients in total in FY2004 was 289,534 (average of 1,196 persons per day), the number of hospitalized patients was 168,926 (average 463 per day), about 83% of patients reside in Saitama prefecture, others are It is a resident of each neighboring prefecture such as Tokyo.

Current concepts in the management of stricture of the urethra

The treatment of urethral strictures is divided into three categories.

First

Management consists of VIU, Dilation, CIC and Diversion.

VIU (Visual Internal Urethrotomy-to incise the stricture with an endoscope) is advocated for short bulbar strictures only once. The results are bad in penile urethral strictures. And it is not advocated for traumatic strictures.

Dilation (Dilatation-expansion of the urethra with metal or plastic dilators) rarely cures a stricture, and is advised in unfit patients, those who refuse surgery, and after multiple failed urethroplasties.

CIC (CSIC-Clean self intermittent catheterization) There is a trend to ask patients to perform CIC after VIU indicating poor success rate of VIU. This method of treatment is not favored by most urethroplasty surgeons in the world.

Diversion (Bypassing normal passage) like perineal urethrostomy, Mitrofanoff procedure is reserved for multiple failed and compex urethroplasties, in older men.

Second

Cure is possible in most patients for traumatic urethral strictures by excision of the stricture and anastomotic urethroplasty. It is applicable to bulbar urethral trauma and fractured pelvis and ruptured posterior urethra.There is a debate going on about whether to transect or not to transect the bulbar urethra for non traumatic urethral strictures. And the mood is swinging in favor of non transection.

Third

To create stable urethra of normal caliber. We cannot excise long segments of urethral strictures without chordee. For long strictures and those of non traumatic in origin augmentation urethroplasty (patch) with oral mucosa graft is the treatment of choice.

Guido Barbagli revolutionized the treatment of long segment urethral strictures by his dorsal onlay graft technique.

We (Kulkarni and Barbagli) described a new technique of one side dissection, dorsal onlay BMG urethroplasty for bulbar, penile and full length urethroplasty. We preserve the neurovascular tissue on one side of the urethra. This new technique is an example of minimal invasive technique of urethroplasty.

Today with only two urethroplasty techniques namely anastomosis and one side dissection we can perform surgery in more than 90% of the patients of stricture of the urethra. Complex cases need variety of procedures fit to be performed in centers of excellence and devoted to the treatment of stricture urethra.