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Review
. 2022 Nov;40(11):2591-2600.
doi: 10.1007/s00345-022-04131-y. Epub 2022 Aug 26.

Posterior urethral stenosis: a comparative review of the guidelines

Behzad Abbasi  1 , Nathan M Shaw  1   2 , Jason L Lui  1 , Kevin D Li  1 , Architha Sudhakar  1 , Patrick Low  1 , Nizar Hakam  1 , Behnam Nabavizadeh  1 , Benjamin N Breyer  3   4
Affiliations
Review

Posterior urethral stenosis: a comparative review of the guidelines

Behzad Abbasi et al. World J Urol. 2022 Nov.

Abstract

Purpose: We aimed to provide a thorough comparative review of the available guidelines on the diagnosis, management, and follow-up for patients with posterior urethral stenosis by the American Urologic Association (2016), Société Internationale d'Urologie (2010), and European Urologic Association (2022).

Methods: The AUA, SIU, and EAU guidelines were evaluated for recommendations on the diagnosis, evaluation, and treatment of posterior urethral stenosis. We also included the EAU and AUA urologic trauma guidelines for the trauma-related stenosis. The level or strength of recommendations is included in case of disparity between the guidelines.

Results: The three guidelines align considerably in recommendations provided for the diagnosis, management, and follow-up of patients with posterior urethral stenosis. SIU and EAU emphasize the role of repeat endoscopic treatment in guidelines compared to AUA.

Conclusion: The preferred method to repair bulbo-membranous stricture/stenosis following radiation therapy remains an area of active interest, focusing on continence preservation. Additionally, there may be a role for advanced endoscopic treatments with or without adjunct therapies to manage even obliterated stenoses.

Keywords: Bladder neck contracture; Pelvic fracture urethral injury; Posterior; Urethral stenosis; Urethral stricture; Vesico-urethral anastomotic stenosis.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Guidelines on the management of posterior urethral obstruction due to surgical procedures for the management of benign prostate hyperplasia. AUA, American Urologic Association; EAU, European Urologic Association; BNC, Bladder neck contracture; BMS, Bulbomembranous stricture; DVIU, Direct-vision internal urethrotomy; TUR, trans-urethral resection; ISD, Intermittent self-dilation; EPA, Excision and primary anastomosis
Fig. 2
Fig. 2
Guidelines on the management of posterior urethral obstruction due to pelvic irradiation. SIU, Société Internationale d’Urologie; EAU, European Urologic Association; BNC, Bladder neck contracture; BMS, Bulbomembranous stricture; DVIU, Direct-vision internal urethrotomy; TUR, trans-urethral resection; ISD, Intermittent self-dilation; EPA, Excision and primary anastomosis
Fig. 3
Fig. 3
Guidelines on the management of bladder neck contracture due to radical prostatectomy. AUA, American Urologic Association; SIU, Société Internationale d’Urologie; EAU, European Urologic Association; BNC, Bladder neck contracture; DVIU, Direct-vision internal urethrotomy; TUR, trans-urethral resection; CIC, Clean intermittent catheterization; UI, Urinary incontinence
See this image and copyright information in PMC

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