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Urology. 2014 Feb;83(2):477-84. doi: 10.1016/j.urology.2013.10.043. Epub 2013 Dec 19.

Male urethral strictures: a national survey among urologists in Italy.

Author information

1
Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy. Electronic address: enzo.palminteri@inwind.it.
2
Department of Urology, San Donato Hospital, Milan, Italy.
3
Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
4
Department of Scienze Ginecologico-Ostetriche e Scienze Urologiche, Sapienza University, Rome, Italy.
5
Department of Urology, Le Molinette Hospital, Torino, Italy.
6
Clinica Urologica I, Università degli Studi di Milano, Fondazione IRCCS Ospedale Maggiore Policlinico, Ca' Granda, Milan, Italy.

Abstract

OBJECTIVE:

To determine national practice patterns in the management of male urethral strictures among Italian urologists.

METHODS:

We conducted a survey using a nonvalidated questionnaire mailed to 700 randomly selected Italian urologists. Data were registered into a database and extensively evaluated. Analysis was performed using SAS statistical software (version 9.2). Statistical significance was defined as P ≤.05.

RESULTS:

A total of 523 (74.7%) urologists completed the questionnaire. Internal urethrotomy and dilatation were the most frequently used procedures (practiced by 81.8% and 62.5% of responders, respectively), even if most urologists (71.5%) considered internal urethrotomy appropriate only for strictures no longer than 1.5 cm; 12% of urologists declared to use stents. Overall, minimally invasive techniques were performed more frequently that any open urethroplasty (P = .012). Particularly, 60.8% of urologists did not perform urethroplasty surgery, 30.8% performed 1-5 urethroplasties yearly, and only 8.4% performed >5 urethroplasty surgeries yearly. The most common urethroplasty surgery was one-stage graft technique, particularly using oral mucosa and ventrally placed. Diagnostic workup and outcome assessment varied greatly.

CONCLUSION:

In Italy, minimally invasive procedures are the most commonly used treatment for urethral stricture disease. Only a minimal part of urologists perform urethroplasty surgery and only few cases per year. The most preferred techniques are not traditional anastomotic procedures but graft urethroplasties using oral mucosa; the graft is preferably ventrally placed rather than dorsally. There is no uniformity in the methods used to evaluate urethral stricture before and after treatment.

Comment in

PMID:
24360068
DOI:
10.1016/j.urology.2013.10.043
[Indexed for MEDLINE]

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