You have accessJournal of UrologyTrauma/Reconstruction: Urethral Reconstruction (including Stricture) II1 Apr 2015PD14-12 HETEROGENOUS DISEASE CHARACTERISTICS IN PATIENTS WITH THE CLINICAL DIAGNOSIS OF LICHEN SCLEROSUS Peter Kirk, Heather Crossley, Miriam Hadj-Moussa, and Bahaa Malaeb Peter KirkPeter Kirk More articles by this author , Heather CrossleyHeather Crossley More articles by this author , Miriam Hadj-MoussaMiriam Hadj-Moussa More articles by this author , and Bahaa MalaebBahaa Malaeb More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1341AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lichen sclerosus (LS) in men is poorly understood. The diagnosis is often clinical and encompasses a range of presentations. Typically, it involves penile glans or skin scarring with or without urethral involvement. We sought out to evaluate the degree of heterogeneity among an adult male population with the clinical diagnosis of LS. METHODS We identified adult male patients evaluated at our institution with the diagnosis of LS between 01/2004 and 03/2014. We collected data on patients' age, BMI, comorbidities, social habits, disease characteristics, urethral involvement, pathology, urine analysis, and surgical procedures performed. We compared patients based on BMI, and presence of a biopsy proven disease and assessed for different disease presentations. We also compared patients with and without urethral involvement. Descriptive statistics and comparative statistics (two tailed t-test and Chi square) were used to analyze the data. RESULTS we identified 94 patients with LS. Mean age at diagnosis among these patients was 51.5 years, while mean body mass index (BMI) was 35.3. Prevalence of hypertension, coronary artery disease (CAD), and diabetes was 51.1%, 18.1%, 33.0%, respectively. 58 patients (61.7%) were present or past smokers. Interestingly, 70.2 % of patients (66/94) carried the diagnosis without a biopsy proven disease and strictly based on physical examination. 67 patients (71.3%) had urethral strictures involving pendulous, bulbar or both regions of the urethra and 45.7% had a BMI over 35. Skin scarring involved the meatus in 30 patients (44.1%) and the glans in 22 patients (23.4%), with the most severe form presenting as buried penis in 15 patients (22.1%). Balanitis was present in 28 (30.1%) patients and was significantly more common in patients with BMI over 35 and patients without strictures (p =0.015 and p =0.012, respectively). Patients with strictures were younger than those without (50.1 vs 65.7 years, p <0.01). There was no difference among patients age, BMI, comorbidities, urethral involvement, or other disease characteristics measured between strict clinical diagnosis and biopsy proven disease. CONCLUSIONS This cohort highlights the diversity of disease characteristics among patients with clinical diagnosis of LS. While skin scarring, whitish discoloration and thinning of the skin are attributes of the disease, these are not pathognomonic to LS. A revision of the disease definition is prudent and needs to delineate different categories of the condition. we suggest two: Genital skin scarring, and urethral stricture disease due to LS. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e323 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Kirk More articles by this author Heather Crossley More articles by this author Miriam Hadj-Moussa More articles by this author Bahaa Malaeb More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...