Nicolaas Lumen1, Felix Campos-Juanatey2, Tamsin Greenwell3, Francisco E Martins4, Nadir I Osman5, Silke Riechardt6, Marjan Waterloos7, Rachel Barratt3, Garson Chan8, Francesco Esperto9, Achilles Ploumidis10, Wesley Verla11, Konstantinos Dimitropoulos12. 1. Division of Urology, Gent University Hospital, Gent, Belgium. Electronic address: Nicolaas.lumen@uzgent.be. 2. Urology Department, Marques de Valdecilla University Hospital, Santander, Spain. 3. Department of Urology, University College London Hospital, London, UK. 4. Department of Urology, Santa Maria University Hospital, University of Lisbon, Lisbon, Portugal. 5. Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK. 6. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 7. Division of Urology, Gent University Hospital, Gent, Belgium; Division of Urology, AZ Maria Middelares, Gent, Belgium. 8. Division of Urology, University of Saskatchewan, Saskatoon, Canada. 9. Department of Urology, Campus Biomedico University of Rome, Rome, Italy. 10. Department of Urology, Athens Medical Centre, Athens, Greece. 11. Division of Urology, Gent University Hospital, Gent, Belgium. 12. Aberdeen Royal Infirmary, Aberdeen, UK.
Abstract
OBJECTIVE: To present a summary of the 2021 version of the European Association of Urology (EAU) guidelines on management of male urethral stricture disease. EVIDENCE ACQUISITION: The panel performed a literature review on these topics covering a time frame between 2008 and 2018, and used predefined inclusion and exclusion criteria for the literature to be selected. Key papers beyond this time period could be included as per panel consensus. A strength rating for each recommendation was added based on a review of the available literature and after panel discussion. EVIDENCE SYNTHESIS: Management of male urethral strictures has extensively been described in literature. Nevertheless, few well-designed studies providing high level of evidence are available. In well-resourced countries, iatrogenic injury to the urethra is one of the most common causes of strictures. Asymptomatic strictures do not always need active treatment. Endoluminal treatments can be used for short, nonobliterative strictures at the bulbar and posterior urethra as first-line treatment. Repetitive endoluminal treatments are not curative. Urethroplasty encompasses a multitude of techniques, and adaptation of the technique to the local conditions of the stricture is crucial to obtain durable patency rates. CONCLUSIONS: Management of male urethral strictures is complex, and a multitude of techniques are available. Selection of the appropriate technique is crucial, and these guidelines provide relevant recommendations. PATIENT SUMMARY: Injury to the urethra by medical interventions is one of the most common reasons of male urethral stricture disease in well-resourced countries. Although different techniques are available to manage urethral strictures, not every technique is appropriate for every type of stricture. These guidelines, developed based on an extensive literature review, aim to guide physicians in the selection of the appropriate technique(s) to treat a specific type of urethral stricture.
OBJECTIVE: To present a summary of the 2021 version of the European Association of Urology (EAU) guidelines on management of male urethral stricture disease. EVIDENCE ACQUISITION: The panel performed a literature review on these topics covering a time frame between 2008 and 2018, and used predefined inclusion and exclusion criteria for the literature to be selected. Key papers beyond this time period could be included as per panel consensus. A strength rating for each recommendation was added based on a review of the available literature and after panel discussion. EVIDENCE SYNTHESIS: Management of male urethral strictures has extensively been described in literature. Nevertheless, few well-designed studies providing high level of evidence are available. In well-resourced countries, iatrogenic injury to the urethra is one of the most common causes of strictures. Asymptomatic strictures do not always need active treatment. Endoluminal treatments can be used for short, nonobliterative strictures at the bulbar and posterior urethra as first-line treatment. Repetitive endoluminal treatments are not curative. Urethroplasty encompasses a multitude of techniques, and adaptation of the technique to the local conditions of the stricture is crucial to obtain durable patency rates. CONCLUSIONS: Management of male urethral strictures is complex, and a multitude of techniques are available. Selection of the appropriate technique is crucial, and these guidelines provide relevant recommendations. PATIENT SUMMARY: Injury to the urethra by medical interventions is one of the most common reasons of male urethral stricture disease in well-resourced countries. Although different techniques are available to manage urethral strictures, not every technique is appropriate for every type of stricture. These guidelines, developed based on an extensive literature review, aim to guide physicians in the selection of the appropriate technique(s) to treat a specific type of urethral stricture.
Authors: Felix Campos-Juanatey; Enrique Fes-Ascanio; Jan Adamowicz; Fabio Castiglione; Andrea Cocci; Guglielmo Mantica; Clemens Rosenbaum; Wesley Verla; Malte W Vetterlein; Marjan Waterloos; Luis A Kluth Journal: J Clin Med Date: 2022-04-22 Impact factor: 4.241
Authors: Pankaj M Joshi; Marco Bandini; Sandeep Bafna; Vipin Sharma; Amey Patil; Shreyas Bhadranavar; Christian Yepes; Guido Barbagli; Francesco Montorsi; Sanjay B Kulkarni Journal: Eur Urol Open Sci Date: 2021-11-25
Authors: Felix Campos-Juanatey; Ainara Azueta Etxebarria; Paola Calleja Hermosa; Sara Marcos Gonzalez; Eneko Alonso Mediavilla; Miguel Angel Correas Gomez; Jose Antonio Portillo Martin; Jose Luis Gutierrrez Baños Journal: J Clin Med Date: 2022-04-06 Impact factor: 4.241