Validation Study of the LSE Classification and Scoring System in Comparison With U-Score

Abstract

OBJECTIVETo validate the value of the LSE classification and scoring system in predicting surgical outcomes for male anterior urethral stricture cases. METHODSA retrospective review was conducted on 566 patients who underwent urethroplasty between August 2004 and March 2022. After excluding pelvic fracture urethral injury and non-stricture diseases and incomplete data, 358 patients were classified according to the LSE classification system, and both U score and LSE score were calculated. We investigated the relationship between LSE score and U score in predicting recurrence. Recurrence was defined as any instance requiring re-intervention. To identify factors contributing to recurrence, logistic regression analysis was performed on the LSE score and variables not included in the scoring system. RESULTSThe breakdown of S, and E components showed external trauma as the most common cause of strictures, with proximal bulbar urethra being the most common segment. Significant associations were observed between stricture etiology and segment, as well as between surgical technique and segment. A strong correlation (r = 0.73) was found between U score and LSE score, with no significant difference in predicting recurrence between the two scores. Surgical complexity differed significantly between LSE score groups, but surgical duration did not. Patients with LSE < 7 showed a better recurrence rate in Kaplan-Meier analysis. Multivariate logistic analysis identified LSE ≥ 7 as an independent risk factor for recurrence. CONCLUSIONThe LSE classification system and scoring system demonstrate validity in characterizing anterior urethral strictures and predicting surgical outcomes.