Male Urethral Stricture: American Urological Association Guideline
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- 作者：Hunter Wessells ; Keith W. Angermeier ; Sean Elliott ; Christopher M. Gonzalez ; Ron Kodama ; Andrew C. Peterson ; James Reston ; Keith Rourke ; John T. Stoffel ; Alex J. Vanni ; Bryan B. Voelzke ; Lee Zhao ; Richard A. Santucci
- 关键词：urethral stricture ; urethra ; penis
- 刊名：The Journal of Urology
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：197
- 期：1
- 页码：182-190
- 全文大小：163 K
- 卷排序：197
文摘
The purpose of this Guideline is to provide a clinical framework for the diagnosis and treatment of male urethral stricture.Materials and MethodsA 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.ResultsThe 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.ConclusionsSuccessful 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.