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

Mutlu Deger; Oguz Ozden Cebeci; Tunahan Ates; Serdar Geyik; Reha Girgin; Ozan Bozkurt

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

MUTLU DEGER ^[1] ; OGUZ OZDEN CEBECI ^[4] ; TUNAHAN ATES ^[1] ; SERDAR GEYIK ^[2] ; REHA GIRGIN ^[5] ; OZAN BOZKURT ^[3]
1. [1] Cukurova University
  
  Cukurova University
  
  Turquía
2. [2] Aksaray University
  
  Aksaray University
  
  Turquía
3. [3] Dokuz Eylül University
  
  Dokuz Eylül University
  
  Turquía
4. [4] Department of Urology, Kocaeli Derince Traning and Research Hospital, Saglik Bilimleri University, 41200 Derince, Turkey
5. [5] Department of Urology, Zonguldak Bulent Ecevit University, 67100 Zonguldak, Turkey
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Localización: Archivos españoles de urología, ISSN 0004-0614, Tomo 76, Nº. 7 (September), 2023, págs. 487-493
Idioma: inglés
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Resumen
- 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.