Introduction: Patient B. (53 y.o.) had complaints of difficulty of urination, lower abdominal pain, treatment of BPH and prostatitis in the anamnesis. The above complaints were put forward for several years in a row. Prior to hospitalization, he received treatment – multiple bougieing of the penile urethra for urethral stricture.

Aim: To describe the technique of using elaborate highly qualified urosurgical procedure.

Materials and methods: During a comprehensive examination, the diagnosis was made and adequate surgical treatment was provided.

Results: According to the survey urography and  retrograde cystography,   a pronounced narrowing of bulbous urethra was determined. Uroflowmetry rates were: urinary volume 41ml, average volumetric flow rate 2.8ml/s, flow acceleration 0.42ml/s², time urination 14.7s, total urination time 45.2s, waiting time urination 8.0s, residual urine volume – 150ml. The patient was prepared, consent to the operation has been obtained, there were no contraindications. The patient lying on his back was under ETA. Penile access to the anterior urethra performed. With the Foley catheter and bougie control, the stricture up to 8 cm in length was dissected and incised. Artificial grafts were prepared: a section of the buccal mucosal tissues from the internal surfaces of the inferior lip and left cheek – 4*1 and 3*1.5 cm, respectively. Gauze tampons with antiseptic were installed into the affected areas of the    cavity. The grafts were prepared for transplantation into the area of the narrowed urethra – selection by size and thickness of the layer of the ‘new’ urethra. Tubularization of the artificial components was performed sequentially (using a Foley catheter) with hemostasis control. ‘New’ widened urethra was connected with muscular surrounding by sutures; the total wound was sutured layer-by-layer. Aseptic bandage’s installed. The patient was transferred for a day to ICU, conservative drugs prescription was implemented according to the guidelines in the urological department.

Conclusion: In general, a person was in clinic for 7 days, 5 of them – after the surgery. Fast track method and well compliance has shown good results. After one month of Foley-controlled rehabilitation and conservative treatment, the patient has no complaints like before. It emphasizes the advantage after this kind of surgeries, so they should be provided more widely among such patients.