European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males
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...
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| Veröffentlicht in: | European urology 2021-08, Vol.80 (2), p.201-212 |
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| creator | Campos-Juanatey, Felix Osman, Nadir I. Greenwell, Tamsin Martins, Francisco E. Riechardt, Silke Waterloos, Marjan Barratt, Rachel Chan, Garson Esperto, Francesco Ploumidis, Achilles Verla, Wesley Dimitropoulos, Konstantinos Lumen, Nicolaas |
| description | 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 is |
| doi_str_mv | 10.1016/j.eururo.2021.05.032 |
| format | Article |
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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 is <72 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.
The evaluation and postoperative follow-up of patients with urethral strictures should include an assessment of both symptoms and objective parameters. Herein, we describe recommendations for diagnostic evaluation and follow-up, as well as a classification system for urethral strictures.</description><identifier>ISSN: 0302-2838</identifier><identifier>EISSN: 1873-7560</identifier><identifier>DOI: 10.1016/j.eururo.2021.05.032</identifier><identifier>PMID: 34103180</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Classification ; Constriction, Pathologic ; Diagnosis ; Follow-up ; Follow-Up Studies ; Guidelines ; Humans ; Male ; Perioperative care ; Treatment Outcome ; Urethra ; Urethra - diagnostic imaging ; Urethra - surgery ; Urethral dilatation ; Urethral stricture ; Urethral Stricture - diagnosis ; Urethral Stricture - surgery ; Urethroplasty ; Urethrotomy ; Urologic Surgical Procedures, Male - adverse effects ; Urology</subject><ispartof>European urology, 2021-08, Vol.80 (2), p.201-212</ispartof><rights>2021 European Association of Urology</rights><rights>Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-4728da73206c975defd56fc9d4869499b58f82d846a3e68193cf31d18d8268073</citedby><cites>FETCH-LOGICAL-c362t-4728da73206c975defd56fc9d4869499b58f82d846a3e68193cf31d18d8268073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.eururo.2021.05.032$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34103180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Campos-Juanatey, Felix</creatorcontrib><creatorcontrib>Osman, Nadir I.</creatorcontrib><creatorcontrib>Greenwell, Tamsin</creatorcontrib><creatorcontrib>Martins, Francisco E.</creatorcontrib><creatorcontrib>Riechardt, Silke</creatorcontrib><creatorcontrib>Waterloos, Marjan</creatorcontrib><creatorcontrib>Barratt, Rachel</creatorcontrib><creatorcontrib>Chan, Garson</creatorcontrib><creatorcontrib>Esperto, Francesco</creatorcontrib><creatorcontrib>Ploumidis, Achilles</creatorcontrib><creatorcontrib>Verla, Wesley</creatorcontrib><creatorcontrib>Dimitropoulos, Konstantinos</creatorcontrib><creatorcontrib>Lumen, Nicolaas</creatorcontrib><title>European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males</title><title>European urology</title><addtitle>Eur Urol</addtitle><description>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 is <72 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.
The evaluation and postoperative follow-up of patients with urethral strictures should include an assessment of both symptoms and objective parameters. Herein, we describe recommendations for diagnostic evaluation and follow-up, as well as a classification system for urethral strictures.</description><subject>Classification</subject><subject>Constriction, Pathologic</subject><subject>Diagnosis</subject><subject>Follow-up</subject><subject>Follow-Up Studies</subject><subject>Guidelines</subject><subject>Humans</subject><subject>Male</subject><subject>Perioperative care</subject><subject>Treatment Outcome</subject><subject>Urethra</subject><subject>Urethra - diagnostic imaging</subject><subject>Urethra - surgery</subject><subject>Urethral dilatation</subject><subject>Urethral stricture</subject><subject>Urethral Stricture - diagnosis</subject><subject>Urethral Stricture - surgery</subject><subject>Urethroplasty</subject><subject>Urethrotomy</subject><subject>Urologic Surgical Procedures, Male - adverse effects</subject><subject>Urology</subject><issn>0302-2838</issn><issn>1873-7560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Ud1qFDEUDqLYtfoGIrms0BnzM8lkvBBKbatQsaB7HdLkzJolm6xJptKX8JlN2eqlVwfO98c5H0KvKekpofLdtoclLzn1jDDaE9ETzp6gFVUj70YhyVO0IpywjimujtCLUraEEC4m_hwd8YESThVZod8XzWIPJuKzUpL1pvoUcZrxOqeQNvf4avEOgo9QcAPWGeqPbAL-VrO3dcmAP_oCpgA-uTG5Yvb2fduYTUzFl1N8A9k3-9xs7wB_MdFsYAexnmITHb5MIaRf3bLHPjYwQHmJns0mFHj1OI_R-vLi-_mn7vrr1efzs-vOcslqN4xMOTNyRqSdRuFgdkLOdnKDktMwTbdCzYo5NUjDQSo6cTtz6qhyiklFRn6MTg6--5x-LlCq3vliIQQTIS1FM8EnwQbGSKMOB6rNqZQMs95nvzP5XlOiH5rQW31oQj80oYnQrYkme_OYsNzuwP0T_X19I3w4EKDdeech62I9RAvOZ7BVu-T_n_AHA9acdA</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Campos-Juanatey, Felix</creator><creator>Osman, Nadir I.</creator><creator>Greenwell, Tamsin</creator><creator>Martins, Francisco E.</creator><creator>Riechardt, Silke</creator><creator>Waterloos, Marjan</creator><creator>Barratt, Rachel</creator><creator>Chan, Garson</creator><creator>Esperto, Francesco</creator><creator>Ploumidis, Achilles</creator><creator>Verla, Wesley</creator><creator>Dimitropoulos, Konstantinos</creator><creator>Lumen, Nicolaas</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202108</creationdate><title>European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males</title><author>Campos-Juanatey, Felix ; 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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 is <72 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.
The evaluation and postoperative follow-up of patients with urethral strictures should include an assessment of both symptoms and objective parameters. Herein, we describe recommendations for diagnostic evaluation and follow-up, as well as a classification system for urethral strictures.</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>34103180</pmid><doi>10.1016/j.eururo.2021.05.032</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0302-2838 |
| ispartof | European urology, 2021-08, Vol.80 (2), p.201-212 |
| issn | 0302-2838 1873-7560 |
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| subjects | Classification Constriction, Pathologic Diagnosis Follow-up Follow-Up Studies Guidelines Humans Male Perioperative care Treatment Outcome Urethra Urethra - diagnostic imaging Urethra - surgery Urethral dilatation Urethral stricture Urethral Stricture - diagnosis Urethral Stricture - surgery Urethroplasty Urethrotomy Urologic Surgical Procedures, Male - adverse effects Urology |
| title | European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males |
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