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European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males
- Source :
- European Urology. 80:201-212
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Urethral stricture management guidelines are an important tool for guiding evidence-based clinical practice.To present a summary of the 2021 European Association of Urology (EAU) guidelines on diagnosis, classification, perioperative management, and follow-up of male urethral stricture disease.The panel performed a literature review on the topics covering a time frame between 2008 and 2018, and using predefined inclusion and exclusion criteria for the literature. Key papers beyond this time period could be included if panel consensus was reached. A strength rating for each recommendation was added based on a review of the available literature after panel discussion.Routine diagnostic evaluation encompasses history, patient-reported outcome measures, examination, uroflowmetry, postvoid residual measurement, endoscopy, and urethrography. Ancillary techniques that provide a three-dimensional assessment and may demonstrate associated abnormalities include sonourethrography and magnetic resonance urethrogram, although these are not utilised routinely. The classification of strictures should include stricture location and calibre. Urethral rest after urethral manipulations is advised prior to offering urethroplasty. An assessment for urinary extravasation after urethroplasty is beneficial before catheter removal. The optimal time of catheterisation after urethrotomy is72 h, but is unclear following urethroplasty and depends on various factors. Patients undergoing urethroplasty should be followed up for at least 1 yr. Objective and subjective outcomes should be assessed after urethral surgeries, including patient satisfaction and sexual function.Accurate diagnosis and categorisation is important in determining management. Adequate perioperative care and follow-up is essential for achieving successful outcomes. The EAU guidelines provide relevant evidence-based recommendations to optimise patient work-up and follow-up.Urethral strictures have to be assessed adequately before planning treatment. Before surgery, urethral rest and infection prevention are advised. After urethral surgery, x-ray dye tests are advised before removing catheters to ensure that healing has occurred. Routine follow-up is required, including patient-reported outcomes. These guidelines aim to guide doctors in the diagnosis, care, and follow-up of patients with urethral stricture.
- Subjects :
- Male
medicine.medical_specialty
Urologic Surgical Procedures, Male
Urethrotomy
Urethral stricture
Urology
Urethroplasty
medicine.medical_treatment
030232 urology & nephrology
Context (language use)
Constriction, Pathologic
03 medical and health sciences
0302 clinical medicine
Urethra
medicine
Humans
Infection control
Urethral Stricture
medicine.diagnostic_test
business.industry
medicine.disease
Endoscopy
Treatment Outcome
medicine.anatomical_structure
030220 oncology & carcinogenesis
Inclusion and exclusion criteria
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 03022838
- Volume :
- 80
- Database :
- OpenAIRE
- Journal :
- European Urology
- Accession number :
- edsair.doi.dedup.....fd5eb04c0c564c5990111a8544f7f332