ARTICLE IN PRESSTHE JOURNALUROLOGYCheck forAUA Guideline Articleupdateswww.auajournals.ong/journal/juroUrethral Stricture Disease Guideline Amendment (2023)Hunter Wessells,1*Allen Morey ,2 Alex Vanni,3 Leila Rahimi,4 and Lesley Souter5University of Washington,Professor and Nelson Chair in Urology,UW Schoo of Medicine,President UW Physicians,Seattle,Washington2 The University of Texas Southwestern Medical Center,Dallas,Texas3Lahey Hospital and Medical Center,Burlington,MassachusettsAmerican Urological Association,Linthicum,MarylandNomadic E.B.M Methodology,Smithville,Ontario,CanadaPurpose:The symptoms of urethral stricture are non-specific and may overlapwith other common conditions that can confound diagnosis.Urologists play a keyAbbreviationsand Acronymsrole in the initial evaluation of urethral stricture,currently provide all acceptedtreatments,and must be familiar with the evaluation,diagnostic tests,andCT =Computerized tomographyscansurgical treatments for urethral stricture.Materials and Methods:A systematic review of the literature using the Pubmed,DVIU Direct visual internalurethrotomyEmbase,and Cochrane databases (search dates January 1,1990 to January 12,2015)was conducted to identify peer-reviewed publications relevant to the diag-IIEF International Index ofnosis and treatment of urethral stricture in men.The review yielded an evidenceErectile Functionbase of 250 articles after application of inclusion/exclusion criteria.The search forLS Lichen sclerosusthe 2023 Amendment was modified to included females and males (searchMRI =Magnetic resonancedates December 2015-October 2022 for males;January 1990-October 2022 forimagingfemales)and a new Key Question on sexual dysfunction was added (search dates:NGB Neurogenic bladderJanuary 1990-10/2022).After inclusion and exclusion criteria were applied,81PFUl =Pelvic fracture urethralstudies were added to the existing evidence base.injuryResults:Once a urethral stricture is diagnosed,clinicians should determine theRUG Retrograde urethrographylength and location of the stricture in order to inform treatment.After a period ofSP Suprapubicurethral rest,patients with short (<2cm)bulbar urethral stricture may be treatedVCUG =Voidingendoscopically.Urethroplasty may be performed by an experienced surgeon incystourethrographypatients with first time or recurrent anterior and posterior urethral strictures.TheVUAS Vesicourethral anasto-best treatment option for urethral stricture in female patients is urethroplastymotic stenosisusing oral mucosa grafts or vaginal flaps rather than endoscopic treatment.Conclusion:This guideline provides evidence-based guidance to clinicians andSubmitted April 6.2023:accepted April 10.patients regarding how to recognize symptoms and signs of a urethral stricture/2023:puh1ed000The complete unabridged version of thestenosis,carry out appropriate testing to determine the location and severity ofguideline is avilable at https://www.jurology.com.the stricture,and recommend the best
