[A modification of Johanson's operation in the treatment of urethral strictures and obliterations].

The choice of operative techniques applicable in urethral strictures and obliterations is rather great today. The author holds that procedures that may entail bladder hypotonia, pyelonephritis, nephrolithiasis, prostatitis, impotence, especially in young patients, should be rejected as ineffective. These complications often result from ignorance of perineal anatomy, erroneous choice of surgical policy leading to bouginage. To avoid it, the surgeon is advised to employ two-stage urethral reconstruction according to B. Johanson. The procedure, proposed in 1950, implies usage of plastic material obtained from penile and scrotal skin. The original variant of the procedure has the disadvantage of confinement only to urethral strictures. We use two new variants of Johanson operation which can abate not only strictures, but obliterations as well. The experience of 1-26-year follow-up indicates feasibility of our modified operations in multiple strictures in combination with other surgical interventions, in urethrorectal and perineal fistulas and in pediatric surgery.