MP52-11 CAN HISTOPATHOLOGICAL DIAGNOSIS OF LICHEN SCLEROSUS IN PATIENTS WITHOUT CLINICAL FINDINGS PREDICT URETHRAL RECONSTRUCTION OUTCOMES?

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II1 Apr 2016MP52-11 CAN HISTOPATHOLOGICAL DIAGNOSIS OF LICHEN SCLEROSUS IN PATIENTS WITHOUT CLINICAL FINDINGS PREDICT URETHRAL RECONSTRUCTION OUTCOMES? Oscar A. Storme, Jeremy B. Tonkin, Jefferson Lin, Ramón Virasoro, Jack M. Zuckerman, Jessica M. DeLong, and Kurt A. McCammon Oscar A. StormeOscar A. Storme More articles by this author , Jeremy B. TonkinJeremy B. Tonkin More articles by this author , Jefferson LinJefferson Lin More articles by this author , Ramón VirasoroRamón Virasoro More articles by this author , Jack M. ZuckermanJack M. Zuckerman More articles by this author , Jessica M. DeLongJessica M. DeLong More articles by this author , and Kurt A. McCammonKurt A. McCammon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.487AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lichen Sclerosus (LS) is a chronic, progressive mucocutaneous inflammatory condition, that causes destructive urethral strictures. The etiology of this condition is unknown. Urethral strictures secondary to this condition are usually suspected by clinical genital exam and confirmed by biopsy, but in many centers of urethral reconstruction, pathologist usually inform only the presence or not of cancer. We reviewed urethral biopsies of patients without clinical findings of LS who received anterior urethroplasty, looking for non-diagnosed LS and correlation with urethral stricture recurrence. METHODS Retrospective chart review of all adult men with anterior urethral strictures that underwent urethroplasty between January 1, 2010 and August 1, 2014. Patients without clinical findings of LS were included. Stricture biopsies were reviewed by a single uropathologist, looking for hyperkeratosis, epidermal thinning or thickening, basal cell vacuolar degeneration, lichenoid lymphocytic infiltrate and subepithelial hyalination. Patients with 0 or 1 feature were considered negative for LS, patients with 2 features were considered suggestive of LS and patients with 3 or more features were considered diagnostic for LS. Data collection included: demographics, preoperative evaluation, urethral stricture recurrence. Recurrence was defined as the requirement of any treatment for the stricture. We analyzed categorical data with chi2, continuous descriptive data statistical analysis was carried out using Graphpad software. Statistical significance p value was considered with < 0.05. RESULTS Ninety-one patients, mean age 49,3 years (SD: +/-14.98), were included. Mean stricture length was 4.158 (SD: +/-3.08). Stricture location was bulbar in 65 patients (71.4%), panurethral 20 (21.9%) and pendulous in 6 (6.6%). Biopsies were negative for LS in 43 patients (47.3%), suggestive of LS in 26 (28.6%) and positive for LS in 22 patients (24,2%). After a mean follow-up of 18.32 months (SD: +/-14.9). Three patients (3.2%) without LS and 3 patients with LS presented recurrence (p=0.3985). CONCLUSIONS Lichen sclerosus was present in an important number of patients who underwent anterior urethroplasty. In this series there is no relation between presence of LS and urethral stricture recurrence. We consider that urethral biopsy must be done in patients with anterior urethral strictures looking for LS presence specially if a skin flap is considered as surgical approach. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e693 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Oscar A. Storme More articles by this author Jeremy B. Tonkin More articles by this author Jefferson Lin More articles by this author Ramón Virasoro More articles by this author Jack M. Zuckerman More articles by this author Jessica M. DeLong More articles by this author Kurt A. McCammon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...