Pan urethral strictures are comparatively less common and the literature about this type of condition was scant and very rare. Pan urethral strictures are a surgical treatment for the reconstructive urologist as so many times there will be shortage of tissue to cover the long segments of narrowing and these strictures are also additional likely to be related with other complications. Likewise, as these strictures are usually because of inflammatory pathologies. Pan urethral strictures were more complex and long strictures that may involve both the bulbar and pendulous urethra. Such strictures were among the more difficult to reconstruct successfully, and requires the use of the complete surgical armamentarium for urethral reconstruction to be successful. The anterior urethral length was average length of 15 to 20 cm. Thus, to construct a pan urethral stricture, the combination of grafts and flaps are needed for reconstruction.
The main causes of panurethral strictures are earlier catheterization, lichen sclerosus and urethral surgery which are often because of inflammatory pathologies.
The frequent pitfall was not properly diagnose the stricture as being pan urethral.
The treatment of each and every individual case will be tailored according to their etiology, history of earlier urethral surgeries, accessibility of the local tissues for flap harvesting, availability for appropriate donor tissue, and the experience and expertise of the surgeon who are treating. In patients with this complicated strictures, previously failed urethroplasties & in patients with very poor quality of urethral plate 2-stage operation is a better choice. In all other conditions, either a graft or flap urethroplasty or if sufficient tissue are not available then grouping of flap and graft gives good success rates.