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Johansen's urethroplasty is a surgical technique developed for the reconstruction of the urethra, particularly beneficial in cases of stricture disease or injury. The procedure is aimed at restoring normal urethral function and ensuring urine can pass unobstructed. The technique begins with a careful evaluation of the stricture's location and extent, sometimes involving imaging studies or urethroscopy to delineate the area accurately. During the operation, a midline incision is typically made, and the tissue surrounding the urethra is meticulously dissected to expose the narrowed segment. Once the stricture is identified, it is excised, and the healthy tissue is analyzed for its viability. In Johansen's approach, a graft is often utilized, which can be derived from various sources such as the buccal mucosa or skin, ensuring that sufficient tissue is available to span the defect created by the excised stricture. This graft is meticulously shaped and sutured into place for optimal alignment and functional restoration. One of the critical aspects of this technique is the tension-free anastomosis, which is essential to promote healing and reduce complications. Throughout the surgery, special attention is given to vascular supply to the graft to enhance integration. After the graft is placed, the urethra is reconstructed, and the incision site is closed layer by layer. Postoperatively, patients are monitored for complications such as infection or graft failure, and they may have a urethral catheter placed to allow for proper healing while minimizing strain on the surgical site. The recovery process can vary based on the individual's health status and the complexity of the stricture but generally involves gradual return to normal activities. One of the significant advantages of Johansen's urethroplasty is its ability to address long segments of urethral stricture disease, which may not be effectively managed by simpler techniques like dilation or direct vision internal urethrotomy. Clinical outcomes of this procedure have shown promising results, with low rates of recurrence in strictures and high patient satisfaction due to restored urinary function. Long-term follow-up is essential to monitor for any late complications or the potential for stricture recurrence, guiding any necessary interventions. Through a combination of meticulous surgical technique and careful patient selection, Johansen's urethroplasty stands out as a robust option for urethral reconstruction, ultimately improving the quality of life for those affected by urethral stricture disease. The evolution and refinement of this technique continue to contribute significantly to the field of urology, highlighting the importance of an individualized approach to patient care and surgical intervention in achieving optimal outcomes.