Contemporary Management of Male Anterior Urethral Strictures by Reconstructive Urology Experts—Results from an International Survey among ESGURS Members
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Descriptive Characteristics of Participating ESGURS Members
3.2. Diagnostic and Follow-Up Strategies
3.3. Management of Urethral Strictures
3.3.1. Endoscopic Techniques
3.3.2. Urethroplasty Techniques
3.4. Clinical Cases
3.5. Opinions
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Question | Options | Nº of Urologists (%) |
---|---|---|
Age group | 30–39 | 10 (20.4) |
40–49 | 9 (18.4) | |
50–59 | 19 (38.8) | |
≥60 | 11 (22.5) | |
Type of practice | Private hospital | 7 (14.3) |
Private teaching hospital | 5 (10.2) | |
Public hospital | 4 (8.2) | |
Public teaching hospital | 33 (67.4) | |
Private hospital | 7 (14.3) | |
Hospital level | Rural commune (<5000 inhabitants) | 0 |
Provincial town (5000–20,000 inhabitants) | 1 (2.0) | |
Medium-sized city (20,000–100,000) inhabitants | 2 (4.1) | |
Major city (>100,000 inhabitants) | 46 (93.9) |
Country of Practice | Nº of Urologists |
---|---|
Italy | 7 |
Germany | 5 |
United Kingdom | 5 |
Belgium | 4 |
Russia | 4 |
India | 3 |
Norway | 3 |
Egypt | 2 |
Israel | 2 |
Netherlands | 2 |
Serbia | 2 |
Spain | 2 |
France | 1 |
Turkey | 1 |
Austria | 1 |
Greece | 1 |
Morocco | 1 |
Colombia | 1 |
Sweden | 1 |
Finland | 1 |
Question | Options | Nº of Urologists (%) |
---|---|---|
Nº of patients with urethral strictures treated during the last year | None | 0 (0) |
1–5 | 3 (6.1) | |
6–10 | 4 (8.2) | |
11–20 | 6 (12.2) | |
Nº of urethroplasties performed during the last year | >20 | 36 (73.5) |
None | 3 (6.4) | |
1–5 | 5 (10.6) | |
6–10 | 2 (4.3) | |
11–20 | 11 (23.4) | |
>20 | 26 (55.3) |
Diagnostic Test | Nº of Urologists (%) | |
---|---|---|
Diagnostic Work-Out | Follow-Up | |
Retrograde urethrogram +/− voiding cysto-urethrography | 46 (93.9) | 27 (57.5) |
Uroflowmetry +/− post-void residual | 44 (89.8) | 45 (95.7) |
Urethro-cystoscopy (flexible/rigid) | 32 (65.3) | 14 (29.8) |
Urethral ultrasonography | 10 (20.4) | 3 (6.4) |
Urethral calibration | 5 (10.2) | 6 (12.8) |
IPSS * | 16 (32.7) | 13 (27.7) |
PROM ** urethra | 21 (42.9) | 20 (42.6) |
Other questionnaires (i.e., IIEF ***) | 16 (32.7) | 13 (27.7) |
Techniques | Nº of Urologists (%) | |
---|---|---|
Endoscopic procedures | Urethral dilation | 31 (63.3) |
Patient intermittent self-dilations/CIC * | 28 (57.1) | |
Direct vision endoscopic internal urethrotomy (Sachse) | 39 (79.6) | |
Blind endoscopic internal urethrotomy (Otis) | 14 (28.6) | |
Laser endoscopic internal urethrotomy | 8 (16.3) | |
Endo-urethral stent implantation (Memokath, Urolume, Allium) | 6 (12.2) | |
Urethroplasty (open) procedures | External meatotomy | 22 (44.9) |
Meatoplasty | 42 (85.7) | |
End-to-end anastomotic urethroplasty | 41 (83.7) | |
“Non-transecting” anastomotic urethroplasty | 31 (63.4) | |
Urethroplasty using skin flaps (preputial, penile, scrotal) | 30 (61.2) | |
Urethroplasty using grafts (skin, oral mucosa) | 45 (91.8) | |
Perineal urethrostomy | 38 (77.6) |
Urethroplasty Technique | Nº of Urologists (%) |
---|---|
Urethroplasty using grafts (preputial, oral mucosa) dorsally located | 16 (36.4) |
End-to-end anastomotic urethroplasty | 14 (31.8) |
Urethroplasty using grafts (preputial, oral mucosa) ventrally located | 13 (29.5) |
Urethroplasty using skin flaps (preputial, penile, scrotal) | 1 (2.3) |
Urethroplasty Technique | Nº of Urologists (%) |
---|---|
Refer the patient to another Urologist from my Hospital | 3 (6.4) |
Refer the patient to another Hospital | 1 (2.1) |
Urethral dilation | 2 (4.3) |
Endoscopic internal urethrotomy (cold knife, laser) | 3 (6.4) |
Endoscopic internal urethrotomy (cold knife, laser) + patient self-dilations/CIC * | 2 (4.3) |
End-to-end anastomotic urethroplasty | 2 (4.3) |
“Non-transecting” anastomotic urethroplasty | 1 (2.1) |
Urethroplasty using grafts (preputial, oral mucosa) dorsally located | 22 (46.8) |
Urethroplasty using grafts (preputial, oral mucosa) ventrally located | 11 (23.4) |
Urethroplasty Technique | Nº of Urologists (%) |
---|---|
Refer the patient to another Urologist from my Hospital | 4 (8.7) |
Endoscopic internal urethrotomy | 1 (2.2) |
Endoscopic internal urethrotomy (cold knife, laser) + patient self-dilations/CIC * | 2 (4.4) |
End-to-end anastomotic urethroplasty | 14 (30.4) |
“Non-transecting” anastomotic urethroplasty | 11 (23.9) |
Urethroplasty using grafts (skin, oral mucosa) dorsally located | 5 (10.9) |
Urethroplasty using grafts (skin, oral mucosa) ventrally located | 9 (19.6) |
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Campos-Juanatey, F.; Fes-Ascanio, E.; Adamowicz, J.; Castiglione, F.; Cocci, A.; Mantica, G.; Rosenbaum, C.; Verla, W.; Vetterlein, M.W.; Waterloos, M.; et al. Contemporary Management of Male Anterior Urethral Strictures by Reconstructive Urology Experts—Results from an International Survey among ESGURS Members. J. Clin. Med. 2022, 11, 2353. https://doi.org/10.3390/jcm11092353
Campos-Juanatey F, Fes-Ascanio E, Adamowicz J, Castiglione F, Cocci A, Mantica G, Rosenbaum C, Verla W, Vetterlein MW, Waterloos M, et al. Contemporary Management of Male Anterior Urethral Strictures by Reconstructive Urology Experts—Results from an International Survey among ESGURS Members. Journal of Clinical Medicine. 2022; 11(9):2353. https://doi.org/10.3390/jcm11092353
Chicago/Turabian StyleCampos-Juanatey, Felix, Enrique Fes-Ascanio, Jan Adamowicz, Fabio Castiglione, Andrea Cocci, Guglielmo Mantica, Clemens Rosenbaum, Wesley Verla, Malte W. Vetterlein, Marjan Waterloos, and et al. 2022. "Contemporary Management of Male Anterior Urethral Strictures by Reconstructive Urology Experts—Results from an International Survey among ESGURS Members" Journal of Clinical Medicine 11, no. 9: 2353. https://doi.org/10.3390/jcm11092353
APA StyleCampos-Juanatey, F., Fes-Ascanio, E., Adamowicz, J., Castiglione, F., Cocci, A., Mantica, G., Rosenbaum, C., Verla, W., Vetterlein, M. W., Waterloos, M., Kluth, L. A., & on behalf of the Trauma and Reconstructive Urology Working Party of the European Association of Urology Young Academic Urologists (EAU YAU). (2022). Contemporary Management of Male Anterior Urethral Strictures by Reconstructive Urology Experts—Results from an International Survey among ESGURS Members. Journal of Clinical Medicine, 11(9), 2353. https://doi.org/10.3390/jcm11092353