Establishment of the U.L.T.R.A. measurement rating system for anterior urethral stricture.

Abstract

Anterior urethral stricture treatments are various, and comprehensive consideration should be given in selecting individualized treatment programs, which must be combined with the patient's stricture, length, complexity, and other factors. At present, there is no standard for the clinical description of the anterior urethral stricture for the selection of the characteristic index, and most of the indicators are qualitative information. In order to achieve consistent decisions and effective comparisons, it is imperative to establish a standardized description system. We used ultrasound contrast technology in the diagnosis of urethral stricture to establish a reliable measurement scoring system, for the refinement grading of the treatment, so as to objectively guide the establishment of treatment decisions. A retrospective search of PubMed English literatures on anterior urethral stricture (January 1975-September 2016) was conducted, combined with a large number of clinical practice experience. We screened the five most closely related and highly repeatable anatomical characteristic indicators of anterior urethral stricture as a base of establishing the U.L.T.R.A. measurement scoring system. With the evaluation system, individualized cases can be made according to the severity of the stenosis preoperative pathological state from the five aspects of refinement grading, and estimated results of the success rate and prognosis of different surgical treatments for patients according to the score. The evaluation system consists of five indicators: (U) urethral stricture site, (L) length, (T) urethral stricture scar thickness, (R) stricture and stricture with a 10-mm proximal urethral dilatation ratio (stricture diameter ratio for short), and (A) alone urethral stricture or multiple urethral stricture; as well as other characteristics. Suffix (l) refers specifically to anterior urethral stricture due to the lichen sclerosus. The U.L.T.R.A. measurement scoring system proposed through urethral ultrasonography is a standardized system, which is a repeatable disease assessment tool. The five characteristic factors that were most associated with anterior urethral stricture were summarized. Through this, we can more accurately describe the degree of the disease and refinement grade the complexity of the treatment, and enable imaging technologists and surgeons to establish effective communication channels.