Case report:

A 37-year-old female presented to our outpatient department with a history of repeated urethral dilatation for obstructive LUTS for the last 2 years. Her frequency of dilatation has increased recently for the last 3 months. Her MCU was done and was suggested mid and distal urethral stricture (Fig1).

Uroflowmetry also suggested a poor flow of 4.2 ml/sec with a voided volume of 285 ml. Routine blood investigations were regular except for the urine culture, which showed more than one lakh growth of E. coli. Antibiotics were started according to the culture. The patient was advised reconstructive surgery and explained the procedure's pros and cons. She underwent dorsal onlay graft urethroplasty using the buccal mucosal graft (BMG) (Fig 3- 7). Her foley catheter was removed after 21 days, and she voided well with good satisfaction and without any residual urine. Follow-up MCU (Fig 2) and Uroflowmetry after 3 months suggested a non-obstructive voiding with a good flow of 25 ml/sec. till her last follow-up at 12 months, she maintained a good urinary flow and there were no symptoms of any urinary obstruction.