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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.

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



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


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.


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.


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.

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