Improving the results of urethral stricture treatment using innovative methods

Objective: To analyze current data on the effectiveness of traditional and innovative treatments for urethral strictures. To evaluate the role of adjuvant therapy and the potential for implementing telemedicine and telementoring technologies. To compare the findings with existing clinical guidelines. Materials and Methods: To prepare this review, a systematic search of the scientific literature was conducted for the period from 2000 to 2025. The study utilized PubMed, Web of Science, and Scopus databases. The sample included English-language publications, as well as selected Russian-language materials that met the required reliability criteria. Results: The development and standardization of modern urethroplasty techniques, including tunnel urethroplasty, transurethral dorsal and ventral urethroplasty, and glans-preserving augmentation, contribute to achieving high functional and aesthetic results in the treatment of urethral diseases. The introduction of modern minimally invasive technologies, such as Optilume drug-eluting balloon dilation, has significantly reduced the recurrence rate and improved the quality of life for patients suffering from recurrent strictures. The development and use of postoperative adjuvant pharmacotherapy, including mitomycin C and steroids, as well as new drug delivery systems (hydrogels, biodegradable stents), are aimed at suppressing fibrosis and improving treatment outcomes in the postoperative period. Strengthening mentoring programs using modern telecommunications technologies, such as telemedicine and telementoring, contributes to improving surgical skills and the sustainability of healthcare systems in resource-limited countries. Conclusion: In modern urology, reconstructive treatments for urethral strictures are considered the most reliable and effective, especially for extended lesions, recurrent stenosis, and after unsuccessful endoscopic interventions. Selecting the optimal technique requires a thorough analysis of the anatomical features of the lesion, taking into account previous surgical interventions and comorbidities.