Lichen Sclerosus of the Male Genitalia and Urethral Stricture Diseases

Abstract

Introduction: The true incidence of urethral involvement in patients with genital lichen sclerosus (LS) is unknown. We review the epidemiology and discuss the pathogenesis of LS and urethral stricture diseases. Materials and Methods: During the period 1991–2002, of 925 patients who underwent urethroplasty for anterior urethral stricture, 130 patients (14%) received the diagnosis of LS. In all patients with LS the histology was re-examined to confirm the clinical diagnosis. Retrograde and voiding urethrography was used to establish urethral involvement in the disease. Results: In 106 patients (82%) the histology provided the classical features of LS, and 24 patients (18%) showed some histological variations. In 49 patients (37%) the LS involved the pendolous urethra (meatus-navicularis-penile), and in 53 cases (41%) a panurethral stricture was evident. Conclusions: LS urethral involvement appears to be a much more common and extensive disease than previously reported, and requires particular care in its early diagnosis.

Urethral Reconstruction Using Buccal Mucosa or Penile Skin Grafts: Systematic Review and Meta-Analysis

“…It is however unclear and not determinable whether this is the case in this meta-analysis. LS is a chronic inflammatory disease of unknown origin affecting genital skin, the glans, the meatal orifice and even extending into the urethra [44]. The use of penile skin in UR is obsolete seen the fact that LS has a high chance to recur in the PSG, finally leading the failure of UR [45,46].…”

Tratamiento de la estrechez del meato uretral por balanitis xerótica obliterante: resultados a largo plazo empleando meatoplastia de Malone

“…En la literatura mundial se han publicado al respecto varias técnicas quirúrgicas que ayudan al tratamiento de diferentes tipos de estrecheces uretrales [3][4][5]8,9 . En dichas series se comprobó que el uso de un colgajo de mucosa bucal para reemplazar la zona estrecha defectuosa uretral sigue siendo la técnica con mejores resultados postoperatorios a largo plazo 3,5,9 .…”

“…Puede también aparecer en niños, aunque los datos acerca de su incidencia en este grupo de pacientes no están del todo definidos 2,3 . La BXO puede afectar en un 30% de los casos a la uretra, provocando desde una estrechez focal del meato uretral hasta estrecheces uretrales extensas que afectan toda la fosa navicular [2][3][4][5] . Los síntomas principales de la enfermedad son dolor, malestar peneano local, prurito, erecciones dolorosas y retención urinaria.…”

Genital Skin Flap Urehtroplasty

“…When this affects the genital skin or if it is the cause of the urethral stricture, it makes the skin unusable for urethral reconstruction. (Barbagli et al, 2004) Where a patient has had previous hypospadias repair complicated by urethral stricture, the penile s k i n i s o f p o o r q u a l i t y b e c a u s e o f t h e cicatrisation from previous surgery. (Imamoglu et al, 2003) Such a skin is not ideal for substitution of the urethra.…”