Purpose The purpose of this Guideline is to provide a clinical framework for the diagnosis and treatment of male urethral stricture. Materials and Methods A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1990 to 12/1/2015) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of urethral stricture. The review yielded an evidence base of 250 articles after application of inclusion/exclusion criteria. These publications were used to create the Guideline statements. Evidence-based statements of Strong, Moderate, or Conditional Recommendation were developed based on benefits and risks/burdens to patients. Additional guidance is provided as Clinical Principles and Expert Opinion when insufficient evidence existed. Results The Panel identified the most common scenarios seen in clinical practice related to the treatment of urethral strictures. Guideline statements were developed to aid the clinician in optimal evaluation, treatment, and follow-up of patients presenting with urethral strictures. Conclusions Successful treatment of male urethral stricture requires selection of the appropriate endoscopic or surgical procedure based on anatomic location, length of stricture, and prior interventions. Routine use of imaging to assess stricture characteristics will be required to apply evidence based recommendations, which must be applied with consideration of patient preferences and personal goals. As scientific knowledge relevant to urethral stricture evolves and improves, the strategies presented here will be amended to remain consistent with the highest standards of clinical care.
Bibliographical noteFunding Information:
All panel members completed COI disclosures. Those marked with (C) indicate that compensation was received. Disclosures listed include both topic– and non-topic-related relationships. Consultant/Advisor: Sean Elliott, American Medical Systems (C), GT Urological (C) Meeting Participant or Lecturer: Kenneth Angermeier, American Medical Systems (C); Sean Elliott, American Medical Systems (C); Ron Kodama , Journal of Urology/GURS; Andrew Peterson, American Medical Systems, Inc. (C); Hunter Wessells, National Institutes of Health Scientific Study or Trial: Ron Kodama , Journal of Urology/GURS; Andrew Peterson, American Medical Systems, Inc. (C); John Stoffel, Uroplasty; Hunter Wessells, National Institutes of Health Leadership Position: Sean Elliott, Percuvision (C); Ron Kodama , Journal of Urology/GURS; Andrew Peterson, Society of Government Service Urologists, Southeastern Section— AUA Board of Directors, GURS Board of Directors ; Hunter Wessells, American Board of Urology Other: Christopher Gonzalez, American Medical Systems; Hunter Wessells, National Institutes of Health
© 2017 American Urological Association Education and Research, Inc.
- urethral stricture