Management of Anterior Urethral Strictures in Adults: A Survey of Contemporary Practice in Germany

Abstract

Introduction: Treatment methods of anterior urethral strictures in adults have undergone considerable changes in the recent past. Our goal was to determine national practice patterns among German urologists and to compare results with the results of prior international surveys. Methods: We conducted a survey on the management of urethral strictures among German urologists. Results: Eight hundred forty-five urologists, representing about 14.6% of German urologists, answered the survey. Most common procedures were direct vision internal urethrotomy (DVIU; 87.2%), blind internal urethrotomy (57.5%), dilatation (56.3%), ventral buccal mucosa graft urethroplasty (31.6%) and excision and primary anastomosis (28.9%). In case of a 3.5-cm bulbar stricture and in the case of a 1-cm bulbar stricture after 2 failed DVIUs, a consecutive urethroplasty was significantly more often favoured compared to transurethral treatment options (44.9 vs. 21.3% and 59.4 vs. 8.3%, both p < 0.001). Conclusion: Open urethral reconstruction reveals to be a more common method in practice nowadays. Adherence to recommended treatment algorithms improved in comparison to prior surveys.

Male urethral stricture disease in a regional centre: 10 years of experience

“…19 However, not all patients are suitable for urethroplasty and treatment of male urethral stricture disease needs to be tailored to the individual needs of patients, taking into account both stricture characteristics and patient factors. 20 Other studies in urethral stricture management have focused on urethroplasty outcomes, 21 rely on surveys of clinicians without clinical details, 13,22 or are based on large populations with inherent limitations such as age restrictions and lack of clinical follow up. Little local data exist to highlight the size of this group, or to infer the characteristics of our urethral stricture patients, current patterns of management and their outcomes.…”

“…In addition, understanding the scope of the problem of urethral stricture disease in our society may aid in local health policy, resource allocation, development of training and may ultimately facilitate the conduct of clinical studies. 20 Other studies in urethral stricture management have focused on urethroplasty outcomes, 21 rely on surveys of clinicians without clinical details, 13,22 or are based on large populations with inherent limitations such as age restrictions and lack of clinical follow up. 19 In this study, we examined a urethral stricture cohort from a single regional centre based on diagnosis presenting over a 10-year period in order to characterize their demographics, interventions performed and longer term outcomes.…”

Urethroplasty and Quality of Life: Psychometric Validation of a Dutch Version of the Urethral Stricture Surgery Patient Reported Outcome Measures

“…Standard therapy is urethroplasty as it has higher long-term success rates compared to internal urethrotomy or urethral dilatation. Although urethroplasty is still underused, there is a trend towards an increased utilization [6][7][8][9].…”

The use of S-curved coaxial dilator for urethral dilatation: Experience of a tertiary department

“…[ 1 6 ] Therefore, more and more urologists worldwide have started to favor urethroplasty above the other alternatives. [ 6 11 ] Moreover, the American Urological Association guidelines published in 2016 clearly discourage the repeat endoscopic procedure as an alternative to urethroplasty. [ 2 ]…”