Dr. Benjamin N. Breyer

Yeah.

Yeah, I think that's a fascinating aspect of structure pathophysiology is that sort of that distal stenosis that leads to the proximal disease.

And it's this sort of whether it's, you know, five, 10 times a day, the person's voiding and there's this injury that happens every time they pee because they're having to push to get the pee through this tight little vein.

three french five french area the proximal tissue cracks and you get that squamous metaplasia transformation process and with ls you know you have this other sort of inflammatory component compounding the problem

I think that's the cool thing about Recon.

It really is a toolbox.

I will say that fasciocutaneous flaps, I just don't do them frequently.

I do them maybe one every two years.

Just rare for me to do them.

I think they're a great case and they are a little more technically demanding and usually they go great and there's no problems, but when they go bad, it can be quite

quite a bit of a disaster when the whole thing necroses.

So with the advent of buckle, which is such a versatile craft material, really kind of gotten away from fascia cutaneous flaps.

Besides that though, I mean, most definitely still do anastomotics, excision, you know, EPA.

Most definitely do ventral, dorsal, dorsolateral buckles.

Definitely do...

You know, I don't really do any dorsal, like, really meatal cases.

That's all ventral Nikolovsky approach, transurethral.

That's actually, that changed the game for me because you'd be dealing with fossa strictures that cross the corona and approaching those dorsally and kind of trying to get that plane, as you know, George, is a little treacherous as you're kind of getting into the fossa if you come from the shaft up.

People like...

You know, I know Alex Vanni loves doing approaches, things dorsally at the tip there, and he gets great results.