In surgery, urethroplasty is the repair of an injury or defect within the walls of the urethra. There are four commonly used types of urethroplasty performed; anastomotic, buccal mucosal onlay graft, scrotal or penile island flap (graft), and Johansen's urethroplasty.[1] The choice of procedure is dependent on factors including: physical condition of the patient overall condition of the remainder of the urethra (not affected by the stricture) the length of the defect (best determined by urethrography) multiple or misaligned strictures anatomical positioning of the defect with regard to the prostate gland, urinary sphincter, and ejaculatory duct position of the most patent area of the urethral wall (necessary for determination of the location of the onlay/graft site, most often dorsal or ventral) complications and scarring from previous surgery(ies), stent explantation (if applicable), and the condition of the urethral wall availability of autograft tissue from the buccal cavity (buccal mucosa) (primary selection) availability of autograft tissue from the penis and scrotum (secondary selection) skill level and training of the surgeon performing the procedure