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Photochromic circularly polarized luminescence (CPL) demonstrates broad application prospects in the field of advanced functional materials. However, the current photochromic CPL focuses predominantly on single‐band CPL adjustment, and how to achieve dynamically tunable CPL in multi‐band is still highly challenging. This work reports the success in utilizing reversible photochromism for realizing full‐color CPL emission. Photochromic flexible films are created consisting of triple components: spiropyran (SP) working as photochromic matter, polyurethane (PU) as matrix, and chiral helical polyacetylene as chiral component. Further introducing blue fluorophore 9‐anthracene carboxylic acid (ACA) in the film, blue CPL and red CPL are emitted respectively through selective absorption/transmission and circularly polarized fluorescence energy transfer (CPF‐ET). Doping the photochromic film with diverse fluorophores provides full‐color CPL emission. Adding Zn2+ further intensifies fluorescence and CPL via forming merocyanine (MC)‐Zn2+ complex. Taking advantage of the diverse fluorescence and CPL emission, anti‐counterfeiting, and secondary encryption application of the resulting photochromic CPL materials are demonstrated. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the feasibility and efficacy of a novel biomimetic poly‐l‐lactide (PLLA) nanofiber membrane in repairing anterior urethral strictures from both preclinic and clinic. Biomimetic PLLA membrane was fabricated layer by layer according to the structure of human extracellular matrix. Microstructure, tensile strength, and suture retention strength were fully assessed. Before the clinical application, the safety and toxicology test of the biomimetic PLLA membrane was performed in vitro and in experimental animals. The patients underwent urethroplasty used dorsal onlay or lateral onlay technique. Then, they were followed up for 1 month, 3 months, 6 months, and then annually after the surgery. The mechanical experiments showed well property for application. Biomimetic PLLA membrane was safe according to the in vitro and animal studies. Then, a total of 25 patients (mean age 48.96 years) were included in the study from September 2016 to December 2018. After a mean follow‐up of 33.56 months, 20 patients successfully treated with biomimetic PLLA membrane. Five patients (2 bulbar and 3 penile) suffered postoperational urethral stricture recurrence. None of infection or urinary fistula or any other adverse events related to the use of biomimetic PLLA membrane were observed during the follow‐up period for all patients. The preliminary result confirmed the feasibility and efficacy of the biomimetic PLLA membrane as a novel material for anterior urethral repair. The long‐term effects with more patients should be investigated in further studies. [ABSTRACT FROM AUTHOR]

Peripheral nerve injury (PNI) is a relatively common disease caused by various circumstances, ultimately affecting the life quality of patients. Although existing medications and surgical interventions have particular benefits for nerve repair, more effective therapeutic strategies are urgently needed for various types of nerve injuries. Increasing investigations of nanomaterials have demonstrated their excellent biological properties, such as biocompatibility, permeability, degradability, high medicine loading efficacy, suitable mechanical properties, and broad applications in the biomedical field. Concerning peripheral nerve (PN) repair, nanomaterials with outstanding biological properties can be fitted as nerve conduits to provide support and guidance for PN regeneration and loaded with functional cells, cytokines, or specific medications to promote regenerative outcomes further. Almost all existing studies have focused on the application of different nanomaterials in PN repair, while the application of nanomaterials in different PN injuries has not been taken into account. This article outlines the application of nanomaterials in the medical field and the prevalent therapeutic strategies for PN repair. Importantly, it focuses on the application of nanomaterials in various PNI diseases, covering injuries of the sciatic nerve, cavernous nerve, facial nerve, median nerve, and more. [ABSTRACT FROM AUTHOR]

A novel biomaterial ink consisting of regenerated silk fibroin (SF) and 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO)-oxidized bacterial cellulose (OBC) nanofibrils was developed for 3D printing lung tissue scaffold. Silk fibroin backbones were cross-linked using horseradish peroxide/H2O2 to form printed hydrogel scaffolds. OBC with a concentration of 7wt% increased the viscosity of inks during the printing process and further improved the shape fidelity of the scaffolds. Rheological measurements and image analyses were performed to evaluate inks printability and print shape fidelity. Three-dimensional construct with ten layers could be printed with ink of 1SF-2OBC (SF/OBC = 1/2, w/w). The composite hydrogel of 1SF-1OBC (SF/OBC = 1/1, w/w) printed at 25 °C exhibited a significantly improved compressive strength of 267 ± 13 kPa and a compressive stiffness of 325 ± 14 kPa at 30% strain, respectively. The optimized printing parameters for 1SF-1OBC were 0.3 bar of printing pressure, 45 mm/s of printing speed and 410 μm of nozzle diameter. Furthermore, OBC nanofibrils could be induced to align along the print lines over 60% degree of orientation, which were analyzed by SEM and X-ray diffraction. The orientation of OBC nanofibrils along print lines provided physical cues for guiding the orientation of lung epithelial stem cells, which maintained the ability to proliferate and kept epithelial phenotype after 7 days' culture. The 3D printed SF-OBC scaffolds are promising for applications in lung tissue engineering. [ABSTRACT FROM AUTHOR]

Purpose anterior cervical decompression and fusion is a common surgical procedure. Traditionally, experienced doctors observe X-ray films regularly examined by patients to determine postoperative conditions by observing the tiny movements between the limited vertebral bodies. But it is not accurate. This may lead to error diagnostics and serious deterioration of the condition and secondary injury to the patient and will also put a greater financial burden on them. Doctors need a quantitative standard to determine small motion with limited vertebral landmarks after surgery. Computer vision technology is needed to match the over-extension and over-flexion cervical vertebral body to provide objective measurement data for further quantification of intervertebral activity. Based on conventional scheme, the point mean square error is used as the evaluation criterion of the matching effect, and the iterative matching scheme is proposed to improve the stability of the original scheme. The cervical X-ray films of patients from the China–Japan Friendship Hospital were collected as samples to verify the reliability of the scheme. Compared with the existing image matching schemes based on feature points, our scheme is superior in matching effect, matching speed and stability. This scheme can provide a solid foundation for further assisting doctors in the study of rehabilitation after anterior cervical fusion. [ABSTRACT FROM AUTHOR]

We developed a stromal cell–derived factor‐1 alpha (SDF‐1α)‐aligned silk fibroin (SF)/three‐dimensional porous bladder acellular matrix graft (3D‐BAMG) composite scaffold for long‐section ventral urethral regeneration and repair in vivo. SDF‐1α‐aligned SF microfiber/3D‐BAMG, aligned SF microfiber/3D‐BAMG, and nonaligned SF microfiber/3D‐BAMG scaffolds were prepared using electrostatic spinning and wet processing. Adipose‐derived stem cell (ADSC) and bone marrow stromal cell (BMSC) migration was assessed in the SDF‐1α‐loaded scaffolds. Sustained SDF‐1α release in vitro and vivo was analyzed using enzyme‐linked immunosorbent assay (ELISA) and western blotting, respectively. The scaffolds were used to repair a 1.5 × 1 cm2 ventral urethral defect in male rabbits in vivo. General observation and retrograde urinary tract contrast assessment were used to examine urethral lumen patency and continuity at 1 and 3 months post‐surgery. Postoperative rehabilitation was evaluated using histological detection. The composite scaffolds sustained SDF‐1α release for over 16 days in vitro. SDF‐1α‐aligned SF nanofiber promoted regeneration of urethral mucosa, submucosal smooth muscles, and microvasculature, increased cellular proliferation, and reduced collagen deposition. SDF‐1α expression was increased in reconstructed urethra at 3 months post‐surgery in SDF‐1α‐aligned SF group. SDF‐1α‐aligned SF microfiber/3D‐BAMG scaffolds may be used to repair and reconstruct long urethral defects because they accelerate urethral regeneration. [ABSTRACT FROM AUTHOR]

Objectives: To explore the value of transurethral contrast‐enhanced ultrasonography (CEUS) in the diagnosis and evaluation of female urethral diverticula. Methods: This study prospectively enrolled 35 women with periurethral cystic lesions, who underwent preoperative transurethral CEUS at our single center between April 2015 and May 2017. The diagnosis of a urethral diverticulum was made by the detection of microbubbles inside the lesion. Data regarding the structure and ostia of the diverticula were collected and then compared with intraoperative findings. Results: The median (interquartile range) age of the 35 patients was 43 (34–48) years. The most common manifestations were dysuria (43%) and palpable masses (40%). On transurethral CEUS, 20 patients were found to have urethral diverticula. The diverticula involved the proximal, mid, and distal urethra with different sizes. The shapes of the diverticula were simple in 4 patients (20%), U shaped in 8 patients (40%), and circumferential in 8 patients (40%). A total of 23 ostia were identified. Seventeen women (85%) had 1 ostium, and 3 women (15%) had 2 ostia. Twenty‐one diverticular ostia (91%) were located from the 3‐ to 9‐o'clock positions. The median (interquartile range) distance from the diverticular ostia to the bladder neck was 20 (9–31) mm. During surgery, all US presentations correlated well with surgical findings, and 21 patients were confirmed to have urethral diverticula. The transurethral CEUS had sensitivity of 95% and specificity of 100%. Conclusions: Transurethral CEUS is an effective method for identifying the structure and ostium of female urethral diverticula. It may have a potential role in preoperative planning and surgical management. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine whether it was possible to repair urethral defects with a material of adipose mesenchymal stem cells (ADMSCs)-porous silk fibroin (SF). A total of 39 male New Zealand white rabbits were randomly divided into a control group, an SF group and a bromodeoxyuridine (BrdU)-labeled ADMSCs-SF group (SSF group; n=13/group). Defects were made by resecting the posterior urethral wall. The defects in the SF and SSF groups were repaired using SF and BrdU-labeled ADMSCs-SF materials respectively. Then the anterior wall was sutured, and the urethral catheter was retained for 3 weeks following surgery. The catheter was rinsed with nitrofurazone once a day. The cells with positive expressions of factor VIII related antigen (FVIII-RAg), α-smooth muscle actin (α-SMA) and pan-cytokeratin (AE1/AE3) were detected by immunohistochemical assay, and the distributions of BrdU positive cells and macrophages were observed. Urethrography was performed prior to and following surgery. All rabbits had normal urethral morphologies prior to surgery. The incidence rates of postoperative complications in the control, SF and SSF groups were 76.92 (7/13), 23.07 (3/13) and 15.38% (2/13), respectively (P<0.05). The number of positive macrophages in the SSF group was significantly lower than that of the SF group 4 weeks following surgery (P<0.05). In the SSF group, BrdU positive cells were scattered within the SF material following surgery, primarily at the intersection between the SF material and the urethra. The number of FVIII-RAg positive cells in the SSF and SF groups were significantly different (P<0.05), which were also significantly higher than that of control group (P<0.01). The number of α-SMA positive cells in the SSF and SF groups were significantly different (P<0.05), and these values also significantly exceeded those exhibited by the control group (P<0.01). In addition, the SSF and SF groups had positive staining of AE1/AE3. Similar to normal urethral mucosa, the cytoplasm was stained brownish yellow (P<0.05). It is thus feasible to repair urethral defects using ADMSCs-SF material. [ABSTRACT FROM AUTHOR]

Abstract: Background: We investigated the feasibility of urethral reconstruction using stretched electrospun silk fibroin matrices. Materials and methods: A novel electrospun silk fibroin matrix was prepared. The structure of the material was assessed by scanning electron microscopy and a porosity test. Canine urothelial cells were isolated, expanded, and seeded onto the material for 1 wk to obtain a tissue-engineered graft. The tissue-engineered graft was assessed using hematoxylin and eosin staining and scanning electron microscopy. A dorsal urethral mucosal defect was created in nine female beagle dogs. In the experimental group, tissue-engineered mucosa was used to repair urethra mucosa defects in six dogs. No substitute was used in the three dogs of the control group. Retrograde urethrography was performed at 1, 2, and 6 mo after grafting. The urethral grafts were analyzed grossly and histologically. Results: Scanning electron microscope and a porosity test revealed that the material had a three-dimensional porous structure. Urothelial cells grew on the material and showed good biocompatibility with the stretched silk fibroin matrices. Canines implanted with tissue-engineered mucosa voided without difficulty. Retrograde urethrography revealed no signs of stricture. Histologic staining showed gradual epithelial cell development and stratified epithelial layers at 1, 2, and 6 mo. The canines in the control group showed difficulty in voiding. Retrograde urethrography showed urethra stricture. Histologic staining showed that no or only one layer of epithelial cells developed. A severe inflammatory reaction was also observed in the control group. Conclusions: Stretched electrospun silk fibroin matrices have good biocompatibility with urothelial cells, which could prove to be a potential material for use in urethra reconstruction. [Copyright &y& Elsevier]

Urethral injures, pelvic trauma, and certain congential abnormalities in male can often cause urethral strictures and scarring. Adequate and accurate imaging diagnosis of urethral strictures is critial to select a surgical approach. Although urethrography is commonly used in evaluating male urethral injury and strictures, its limitation is that the contrast offers images only at the urethral lumen but not of the periurethral structures. Sonourethrography (SUG) has the ability to define the periurethral tissues and without the radiation exposure, the degree of periurethral fibrosis can be shown with a view to guiding surgery especially in bulbar urethra. Computed tomography (CT) urethrography has the advantage of examining patients only in one position, and by generating three-dimensional images; it can accurately measure the stricture length. Magnetic resonance imaging (MRI) provide useful information in certain clinical situations, particularly posterior urethral trauma and in the evaluation of the periurethral soft tissues. However, both CT and MRI are relative high cost. The selection of imaging methods should depend on the etiology, sites, patient's general condition and the type of urethral injury, using a rational combination of different imaging methods can improve the accuracy of diagnosis for traumatic urethral strictures. [ABSTRACT FROM AUTHOR]

Abstract: Background: To investigate the feasibility of urethral reconstruction using tissue-engineered buccal mucosa (TEBM) with silk fibroin (SF) matrices in a canine model. Materials and methods: Autologous oral keratinocytes and autologous fibroblasts were isolated, expanded, and seeded onto SF matrices to obtain TEBM. The TEBM was assessed using hematoxylin and eosin staining and scanning electron microscopy. A 5-cm urethral mucosal defect was created in 10 female canines. Urethroplasty was performed using TEBM in five canines in the experimental group and with SF matrices without cells in the five canines in the comparison group. Retrograde urethrography was performed after 6 mo of grafting. The urethral grafts were analyzed grossly and histologically. Results: The oral keratinocytes and fibroblasts exhibited good biocompatibility with the SF matrices. TEBM could be constructed using SF matrices. The canines implanted with the tissue-engineered mucosa voided without difficulty. The retrograde urethrography revealed no sign of stricture. The histologic staining showed that epithelial cells developed gradually and exhibited stratified epithelial layers at 6 mo. In the comparison group, the canines had difficulty voiding, and the retrograde urethrography showed urethra stricture. The histologic staining showed that one to two layers of epithelial cells developed. Conclusions: The TEBM using SF matrices could be a potential material for urethra reconstruction. [Copyright &y& Elsevier]

Background: To provide direct evidence of whether primary realignment (PR) or suprapubic cystostomy (SPC) had different effects on the prostatic displacement and prognosis in patients with pelvic fracture urethral injury who needed delay anastomotic urethroplasty based on Magnetic Resonance (MR) urethrography.Methods: We screened the urethral stenosis database of our single institution from January 2016 to June 2020. Patients who underwent delayed anastomotic urethroplasty with a preoperative MR urethrography and no treatment history of urethra were included. We compared the urethral gap length and prostatic displacement between the PR and SPC group based on MR urethrography. The terminal outcomes such as stenosis-free rate, urinary continence and erectile function were also analyzed between two groups.Results: 66 patients were included in this retrospective study in which 36 were in PR group and 30 in SPC group. Mean follow-up time was 15.1 months (3-38 months). One and two patients experienced recurrence of stenosis after urethroplasty in two groups (p = 1.000). No difference of erectile dysfunction and urinary incontinence was found between two groups. Based on MR urethrography, the urethral gap length was 17.4 mm and 23.3 mm (p = 0.008) which presented a significant decrease in PR group. The superior prostatic displacement was similar in two groups (9.8 mm vs. 13.8 mm, p = 0.081). The numbers and distance of displacement on lateral aspect showed no difference, either. However, PR group had less anterior-posterior prostatic displacement (p = 0.005). Besides, the erectile function was significantly related to the lateral prostatic displacement (p = 0.030/0.047).Conclusions: Based on MR urethrography, patients in PR group showed shorter urethral gap distance and slighter anterior-posterior prostatic displacement without extra erectile dysfunction or incontinence. Besides, patients' erectile function might be significantly related to the lateral prostatic displacement. [ABSTRACT FROM AUTHOR]

Background: To evaluate combined buccal mucosa and lingual mucosa grafts for urethroplasty in a dog model. Materials and Methods: Seven female mongrel dogs were randomly selected. After a segment of proximal urethra mucosa (4cm × 1cm) was excised and onlayed urethroplasty was performed using the combined free buccal mucosa (2cm × 1cm) graft harvested from the inferior cheek and free lingual mucosa graft (2cm × 1cm) harvested from the inferior lateral surface of the tongue. A 12F urethral catheter was kept inside the urethra for a mean of 7 d. Retrograde urethrography was done and urethra diameter was calibrated with a 10Fr catheter before animals were sacrificed at wk 12. After sacrifice of all dogs, the grafted areas excised and evaluated by gross and histopathological examination. Results: All dogs survived the procedure and there were no tongue and oral complications. One of the seven dogs developed a severe urethral stricture near the proximal anastomosis. The remaining six dogs voided spontaneously with no difficulty. Retrograde urethrography showed that no strictures or fistulas had formed. The combined buccal mucosa graft and lingual mucosa graft shortened by 10.2% after surgery, from a mean (SD) of 4 (0.15) to 3.59 (0.23) cm (statistical significance, P < 0.05). No stricture was found in the connection of the buccal mucosa and lingual mucosa grafts. Histologic examination showed that the combined buccal mucosa and lingual mucosa grafts were well-incorporated into the urethral walls and covered by a keratinized squamous epithelium. Conclusions: We successfully developed a dog model for combined buccal mucosa graft and lingual mucosa graft and showed the feasibility of this approach for urethral substitution. [Copyright &y& Elsevier]

Objectives: To investigate the risk factors for postoperative infection, including systemic inflammatory response syndrome, sepsis and surgical site infection, after posterior urethral anastomosis for the treatment of male posterior urethral stenosis with pelvic fractures.Methods: We retrospectively analyzed data from patients who underwent transperineal end-to-end anastomotic urethroplasty between January 2016 and December 2018. Descriptive statistics were used to analyze patient characteristics and perioperative features. Univariate analysis was performed to identify prognostic factors associated with postoperative infection. Multivariate analysis was used to identify independent risk factors for postoperative infection.Results: Among 261 patients included in the analysis, 16.48% had SIRS, 3.83% had sepsis, and 8.05% had SSI. The primary results suggested that penile septum separation, inferior pubic resection, operating duration, preoperative urine culture result, preoperative waiting time, urethral stenosis length, and draining method were significant predictors of postoperative infections. Multivariate analysis revealed that more complex surgical procedures, operating duration and positive urine culture results were independent risk factors for SIRS and preoperative positive urine culture result was an independent risk factor for sepsis and SSI.Conclusions: Positive preoperative urine culture was the main risk factor for postoperative infections. More complex surgical procedures, such as penile septum separation and inferior pubic resection, and longer operating duration were more likely to be associated with postoperative SIRS. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk factors that pertain to stricture recurrence and oral complications.Methods: Patients with long segmented anterior urethral stricture who visited our hospital from 2009 to 2016 were treated with lingual mucosa graft (LMG) urethroplasty. The incidence of complications in all of 128 patients were evaluated. The data were analyzed using the chi-squared test and Fisher's exact test. A multi-factorial regression analysis was performed to identify the risk factors responsible for the recurrence and complications.Results: For patients having LMG urethroplasty, there were no significant difference in recurrence of urethral stricture according to the studied variables. Binary logistic regression analysis reveals that previous surgery involving the urethra was a significant predictor of urethral stricture recurrence (odds ratio [OR]=5.07; 95% confidence interval [95% CI], 1.06-24.40; P = .043). The length of the substitute was significantly related to oral morbidity (P = .020), even after controlling for the studied variables. Patients with a harvested oral mucosa longer than 7 cm had a higher risk of oral morbidity than those with a harvested oral mucosa shorter than 7 cm (OR=4.35; 95% CI, 1.35-14.06; P = .014).Conclusion: Our study shows that LMG urethroplasty is effective for patients with long segmented anterior urethral stricture. Previous urethral surgery was identified as a risk factor to cause recurrence and injury to the tip of the tongue for the oral complications. [ABSTRACT FROM AUTHOR]

The urothelium covers the inner surface of the urinary tract, forming a urinary tract barrier. Impairment of the integrity and dysfunction of the urinary tract barrier is associated with the occurrence and development of various diseases. The development of a three-dimensional model of the urothelium is critical for pathophysiological studies of this site, especially under physiological fluid shear stress stimulated by the urinary flow. In this study, a urothelium on-chip is fabricated with micromilling and replica molding techniques, which contains a microfluidic chip for cell culture and a pump-based fluid perfusion system. The mechanical properties of the human urinary tract are simulated by adjusting the concentration and degree of amino substitution of the gelatin methacrylate hydrogel. The matrix stiffness is similar to the natural urinary tract. Pulsatile flow and periodic flow are provided to simulate the fluid environment of the upper and lower urinary tracts, respectively. The results show that the physiological fluid shear stress could promote the differentiation and maturation of urothelial cells. The model could simulate the three-dimensional structure of urothelium and urinary flow microenvironment, showing morphological structure close to the natural urothelium, specific differentiation and maturation markers (uroplakin 2, cytokeratin 20), and urothelial barrier function., (Creative Commons Attribution license.)

Objective: To explored the curative effects of various surgical methods used to treat complicated posterior urethral strictures in boys and the long-term complication., Methods: We retrospectively studied 28 boys under 14 years of age with complicated posterior urethral strictures treated at our hospital from January 2015 to December 2020. Urethral angiography revealed posterior urethral strictures. Twelve had previously failed urethral surgery; four had urethral fistulae. All underwent end-to-end urethral anastomoses via a transperineal, inferior pubic approach. We freed the distal end of the urethra, split the penile cavernous septum, partially resected the lower edge of the pubic symphysis, and rerouted the urethra under a corpus cavernosum to reduce the tension of the urethral anastomosis., Results: All boys were 2-14 years of age at the time of surgery (mean 6.3 years). The urethral strictures were 3-5.5 cm in length (mean 4.2 cm). Catheters were removed 4 weeks postoperatively. The postoperative follow-up time was 4-72 months (mean 36.8 months). Twenty-four patients exhibited unobstructed urination after a single operation. The maximum urinary flow rate was 15-22 ml/s (average 17.8 ml/s); the success rate was 85.7%. Two patients required second urethral end-to-end anastomoses; urination became normal postoperatively. Two continued to exhibit cystostomies, and two evidenced mild incontinence. Of the six children who have attained puberty, two report erectile dysfunction., Conclusion: End-to-end urethral anastomosis via a transperineal inferior pubic approach is an ideal treatment for posterior urethral strictures in boys. The complications include incontinence and erectile dysfunction, and require long-term follow-up., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Zhu, Song, Sa, Xu and Fu.)

Objective: To investigate the treatment concept of Chinese urologists for anterior urethral strictures based on actual cases., Methods: A self-designed case-based questionnaire was distributed to the members of Official WeChat account of Learning Union from March 19, 2020, to April 10, 2020. Questionnaires requested respondents' demographic information and responses to five cases of anterior urethral stricture: short obliterative bulbar urethral stricture caused by straddle injury (Case 1), idiopathic bulbar urethral stricture after failure of multiple endoscopic therapy (Case 2), iatrogenic long penile urethral stricture (Case 3), lichen sclerosis-related urethral stricture (Case 4), and anterior urethral stricture in indwelling catheter after multiple failure of endoscopic surgery (Case 5). Data was described by frequency and percentage., Results: A total of 1,267 valid anonymous questionnaires were received. Urethroplasty was recommended more frequently than endoscopic surgery (Case 1: 47.8% vs. 32.8%,Case 2: 42.5% vs. 33.8%, Case 3: 36.1% vs. 26.7%). Referrals patients to other urologists engaged in urethral repair and reconstruction account for a high portion of the treatment (Case 1:18.4%, Case 2:23.1%, Case 3:36.5%, Case 4:27.7%,Case 5:9.3%). Excision and primary anastomosis urethroplasty (EPA) was preferred for treatment of Case 1 (42.5%). For Case 2, the most popular choice was EPA (30.6%). Although the patient has a history of failure in endoscopic surgery, 33.8% of urologists continue to choose endoscopic surgery. For Case 3, 20.0% of urologists would perform oral mucosal urethroplasty. Surprisingly, 5.9% chose EPA. For Case 4, 37.3% of urologists selected meatotomy, 30.4% suggested that glans and urethral biopsies should be performed. 21.0% chose to use steroid ointment after surgery. For Case 5, 26.3% of the respondents believed that urethrography should be performed after removing catheter more than one week, if the urine is obstructed during the period, performing cystostomy firstly., Conclusions: In China, the concept of urethroplasty is more widely accepted than endoscopic surgery for the treatment of anterior urethral strictures. The concept of referral has been widely formed among Chinese urologists. Better understanding of the comprehensive treatment of lichen sclerosis related anterior urethral stricture and the principle of urethral rest should be strengthened., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer WZ declared a past collaboration with the authors to the handling editor., (© 2022 Hou, Lin, Gu, Yuan, Wang, Xiu, Fu and Song.)