Definition of Successful Treatment and Optimal Follow-up after Urethral Reconstruction for Urethral Stricture Disease.

The definition of a successful urethroplasty, the lack of need for a secondary procedure, is outdated and must be amended to incorporate objective and subjective outcomes. Success is assigned if a flexible cystoscope can traverse the reconstructed urethra without force. Functional success is assigned if patient-reported outcome measures reveal improvement in voiding symptoms and urinary quality of life. Optimal follow-up strategy allows determination of anatomic and functional outcomes, protects genitourinary health, and prevents excessive invasive testing, unnecessary cost, discomfort, anxiety, and risk. Noninvasive objective uroflowmetry has high sensitivity and specificity for detecting recurrence and replaces invasive anatomic evaluation.