Urethral strictures are common and an important cause of loss of quality of life. Urethral stricture disease is generally defined as stenoses that are typically long, involving broad areas of varying spongiofibrosis, and result from inflammation and/or infection, rather than trauma. Although the management of urethral strictures may be complex and challenging, very often they are treated by health care personnel without the necessary and proper training and knowledge of the current, modern, and validated techniques and procedures. The open surgical repair of urethral strictures has undergone considerable evolution over the last 5 decades. Nowadays, most urethral strictures can be reconstructed in a one-stage procedure, leaving some complex cases for a less convenient but safer two-stage repair strategy. The exciting and enjoyable “nature” of reconstructive surgery, in general, and urethral reconstruction, in particular, is the unexpected and unpredictable nature of the stricture and, consequently, the need of the creative combination of different techniques and strategies, often involving tissue transfer procedures, either as grafts or flaps, for achieving a successful outcome.

In this special issue, several challenges and ongoing (still unresolved) controversies will be reviewed and discussed, and old techniques and procedures will be revisited. Specific topics, such as urethral reconstruction in transsexual surgery, the management of urethral calculus and acquired male diverticula, the tips and tricks of urethroplasty in the patient with an artificial urinary sphincter and a penile prosthesis, and the current role of stents in urethral strictures, will be debated in this issue. The objective of this special issue is to review, discuss, and try to shed light on the potentially successful management of complex urethral disease entities and patients.

Potential topics include, but are not limited to:

• Anterior urethral stricture
• Posterior urethral stricture
• Management of panurethral strictures
• Flaps and grafts in urethral reconstruction
• Tissue-engineering in urethral reconstruction
• Urorectal fistulae: etiology, diagnosis, and surgical management
• Role of staged urethroplasty in adults and children
• Female urethral reconstruction