Open operative procedures for urethral reconstruction (i.e. stricture resection with primary end-to-end anastomosis and buccal mucosa urethroplasty) are established and proven techniques with a low complication profile and high success rates. The aim of this operative technique is removal of the urethral obstruction to avoid far-reaching complications for the whole urinary tract. Despite excellent long-term results, complications are not completely avoidable in both techniques. A successful complication management requires the complete spectrum of reconstructive techniques in addition to appropriate operative expertise in order to be able to achieve the optimal result even in cases of complications. Simultaneously the recognition of potential risks contributes to a further reduction of early and delayed complications both in the approach to the operative intervention as well as intraoperatively.
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