Management Patterns of Male Urethral Stricture Disease among Urologists: What Do the Guidelines Say? What Do Urologists Do?

DEĞER M., Cebeci O. O., Ates T., Geyik S., Girgin R., BOZKURT O.

Archivos espanoles de urologia, vol.76, no.7, pp.487-493, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 76 Issue: 7
  • Publication Date: 2023
  • Doi Number: 10.56434/j.arch.esp.urol.20237607.60
  • Journal Name: Archivos espanoles de urologia
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Gender Studies Database, DIALNET
  • Page Numbers: pp.487-493
  • Keywords: male, stricture, survey, urethral, urologist
  • Dokuz Eylül University Affiliated: Yes


BACKGROUND: The aim of the present study is to evaluate and analyze the daily clinical practice for male urethral stricture disease (MUSD) among urologists. METHODS: Considering the latest guidelines on urethral stricture disease, a survey was developed regarding the various treatment options and preferences in different sites of male urethral stricture disease. The survey was sent to urologists via e-mail and phone application. RESULTS: A total of 266 urologists completed the survey and were included in the final analysis. In regard to workplace, 62 (23.3%), 58 (21.8%), 71 (26.7%), and 75 (28.2%) respondents worked in university hospitals, training and research hospitals, state hospitals, and private practice hospitals, respectively. In regard to the diagnostic method used in male urethral strictures, 88.7% of the participants would choose uroflowmetry + postvoiding residual (UF + PVR), and 64.6% would choose retrograde urethrography (RUG). Direct vision internal urethrotomy (DVIU) was the most frequently chosen method in penile urethral strictures (PUS), being chosen by 72.9%. Direct vision anterior internal urethrotomy was the most common method for both ≤2 cm and >2 cm strictures, 63.1%, and 30.8%, respectively. The most preferred graft for augmentation urethroplasty was buccal mucosa (75.8%). Endoscopic incision/resection (transurethral resection (TUR)) is the most frequently applied treatment method for posterior urethral/vesicourethral anastomotic strictures (86.4%). CONCLUSIONS: The present study clearly shows that most urologists still prefer DVIU and urethral dilatation to urethroplasty in MUSD, which contradicts current guidelines. Urologists should be encouraged to perform urethroplasty and/or refer patients to experienced centres for recurrent MUSD.