Abstract
BackgroundTo investigate the current diagnostic and therapeutic approaches to anterior urethral strictures of Chinese urologists and to compare with developed countries and the American Urologic Association guidelines.MethodsAnonymous questionnaires were distributed to members of Official Wechat Account of urology from March 19, 2020 to April 10, 2020. Descriptive and multiple correspondence analysis were used to analyze the data.ResultsA total of 1276 online questionnaires were received. The response rate was 21.7% (1276/5878). The most common diagnostic methods for anterior urethral stricture were urethrography (90.7%) and urethrocystoscopy (85.4%), while urethral dilation (92.3%) and internal urethrotomy (60.1%) were the main therapeutic procedures. End-to-end urethroplasty (45.2%) was the most common open surgery, followed by skin flap urethroplasty (14.9%) and free graft urethroplasty (12.4%). 76.2% of urologists used urethroplasty only after the failure of minimally invasive surgery (reconstructive ladder treatment strategy). Furthermore, middle-aged or elderly urologists who had attended trainings, had senior practice roles, and who utilized a reconstructive ladder treatment approach were most likely to perform urethroplasties.ConclusionsAnterior urethral stricture treatment in China is still dominated by minimally invasive surgery, with most urologists using the reconstructive ladder treatment strategy. In general, the overall diagnostic and therapeutic strategies were similar between China and developed countries, with some deviations from the American Urologic Association guidelines.
Highlights
Urethral strictures can be traced back to ancient times [1], here is still a poor understanding of this disease
It has been 13 years since the first related survey in the USA [10], our results found that the overall diagnostic and therapeutic approaches to anterior urethral strictures in China have not changed much in comparison to developed countries [9,10,11,12,13]
In terms of the preoperative diagnosis, 78% of Chinese urologists did not rely on a single diagnostic procedure but rather used multiple methods, which is consistent with the American Urologic Association (AUA) guidelines that one individual test cannot make a definitive diagnosis and that retrograde urethrography should be the primary choice [17]
Summary
Urethral strictures can be traced back to ancient times [1], here is still a poor understanding of this disease. The clinical symptoms of patients with anterior urethral strictures are varied, the most apparent symptom is a weakening of the urinary stream. Anterior urethral strictures can generally be diagnosed clinically, a stricture’s site, length, and scar thickness are more difficult to determine [7]. Urethral strictures can be treated surgically using two main approaches: minimally invasive surgery and urethroplasty. The former is generally favored by urologists because of its ease of application and simplicity. To investigate the current diagnostic and therapeutic approaches to anterior urethral strictures of Chinese urologists and to compare with developed countries and the American Urologic Association guidelines
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