Joachim A. Steffens, Petra Anheuser, Adrian E. Treiyer, Britta Reisch and
Peter R. Malone

Treatment of the urethral complications of lichen sclerosus is known to be problematic. Although buccal mucosa grafts or extragenital skin provide the best long-term results for pan-urethral or fossa navicularis strictures [1,2] the surgeon seeking to treat a patient with pure meatal stenosis finds little help from previous reports. The frequent pooling of results from meatal and submeatal strictures, and from children and adults, adds to the difficulty [3,4].

When planning surgery for meatal stenosis, the functional and cosmetic aspects should be considered. An ideal operation  should permanently relieve obstruction, while recreating a slit-like meatus at the tip of the glans penis that allows the patient to
pass urine without spraying [5]. Several operations have been described, including meatal dilatation, simple ventral meatotomy and various types of distal urethroplasty.

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