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Do previous urethral endoscopic procedures and pre-operative self-dilatation increase the risk of stricture recurrence after urethroplasty? Yildirim H1, Wyndaele M1, Hennus P1, de Kort L1 1. University Medical Center Utrecht KEYWORDS: Male, Retrospective Study, Surgery First-line treatment of bulbar urethral strictures in men consists of minimal-invasive endoluminal procedures: dilatation or direct visual internal urethrotomy (DVIU). Recurrence rate at two years after first DVIU is 30 to 60% and increases to 50 to 100% after second urethrotomy (1). Furthermore, repeat transurethral manipulation of bulbar urethral strictures is associated with increased stricture complexity and prolonged disease duration (2). Therefore, both the recent European (European Association of Urology) and American (American Urological Association) guidelines recommend to not perform repetitive endoluminal treatments for anterior urethral strictures in men if urethroplasty is a viable option. Urethroplasty with (transecting or non-transecting) anastomotic repair or free graft urethroplasty have emerged as the standard management for most anterior urethral strictures in men, offering high success rate (up to 90%) (1). Multivariate analyses of risk factors predictive for failure after urethroplasty (such as etiology, stricture length or previous treatments) show conflicting evidence (3). Furthermore, intermittent self-dilatation (ISD), which is also a (repetitive) transurethral manipulation, has not been evaluated as a (independent) risk factor for stricture recurrence after urethroplasty. The aim of this study is to evaluate the relation between the presence and number of prior endoluminal treatments (dilatation, DVIU) and / or ISD, and clinically relevant stricture recurrence after first urethroplasty in men with (peno-) bulbar urethral strictures.