In case that a urethral stricture is associated with the fistula, an anastomotic urethroplasty is performed, either bulbo-prostatic or urethro-vesical in case that the patient had previously undergone a radical prostatectomy. Stepwise maneuvers of the elaborated perineal posterior urethroplasty may be used as necessary to achieve a tension-free anastomosis. The urethra is transected at the point of the fistula and mobilized distally beyond the crus as far as the penoscrotal junction. Then corporeal body separation in bloodless plane is performed from the crus distally for 3–5 cm (a). If after corporal body separation, and inferior wedge pubectomy, a tension-free anastomosis cannot be achieved, the urethra is routed around the lateral side of the left corporal body. A small furrow of the bone should be gouged from the left ischiopubic ramus where the urethra runs, to avoid its compression between the corpus and bone (b).