This protocol applies to transgender female patients (transwomen) who present with a short, non-obliterative urethral stricture. The anatomical context following gender-affirming surgery creates a distinct clinical picture that directly shapes how the stricture is assessed and managed.
Transgender women with a short, non-obliterative urethral stricture — a group in which initial conservative management may be appropriate before progressing to open surgical repair. Stricture location and length at the meatus are the primary drivers of technique selection.
In transwomen, it is acceptable to start with dilatation of a short and non-obliterative stricture as an initial step.
When dilatation is not possible or does not provide lasting relief, open surgical reconstruction is indicated. The choice of meatal reconstruction technique depends on stricture length, with distinct approaches for shorter versus somewhat longer meatal strictures.