Objective: Optimization of urethroplasty results in extended urethral stricture by using vascularized flaps. Methods: The experience of treatment of 12 patients with extended urethral stricture were presented. The clinical material includes the patients with extended strictures of 7 to 18 cm with the average size of 13±3.67 cm of urethra and skin defects. Operations were performed 4-6 months after the epicystostomy application. The results were evaluated by the anamnestic, clinical, dopplerography and retrograde urethrography data. Results: In 9 cases extended urethral strictures were replaced by free revascularized single (6 cases) or double (3 cases) radial flaps. In 3 other cases urethral strictures were replaced by local skin tissues and volar defect of the penis was covered by axial groin flap. In all cases autotransplants were survived with restoration of natural urination, ejaculation and optimal aesthetic outcome were obtained. In one case the infiltration of wound and in another case urethral fistula were developed as the complication. Conclusion: In extended urethral stricture, the size which exceeds 7 cm of using the additional vascularized transplants of soft tissues (free, axial) is the method of the choice for adequate covering urethra tissues and accompanying skin defects of the penis.
