Urethral strictures have long been a therapeutic dilemma for urologists. The natural course of the disease is progressive scarring and narrowing of the urethral lumen. Multiple attempts at developing an optimal therapy have fallen short of an adequate cure rate. Often the procedures have resulted in an increased progression of the length and depth of the stricture rather than resolving the disease. Presently, internal urethrotomy is the primary surgical mode of treatment for most minor and moderate strictures. It has been demonstrated that this procedure, which relies on healing by secondary intention, is more a managerial rather than a curative therapy. The use of an endoscopically placed biocompatible tubular collagen wound dressing to dress the incised wound areas and provide an enlarged conduit after internal urethrotomy offers a potential cure for urethral strictures. The tubular collagen wound dressing functions as a biological dressing to the wound bed. The collagen matrix protects the wound and facilitates the migration of urothelial cells and wound healing. This tubular collagen wound dressing can also be used as a delivery system for growth factors and cultured epithelial cells to further enhance healing and prevent scar formation. The endoscopic application of a tubular collagen wound dressing for the repair of urethral strictures can potentially prevent the progression of the disease and the need for more extensive procedures. Endoscopic insertion, simple in mechanism and short in procedure will lead to good marketability and acceptability in the urological medical community.
