Division of Urology, Gent University Hospital, Gent, Belgium.
Urology Department, Marques de Valdecilla University Hospital, Santander, Spain.
Eur Urol. 2021 Aug;80(2):190-200. doi: 10.1016/j.eururo.2021.05.022. Epub 2021 May 29.
To present a summary of the 2021 version of the European Association of Urology (EAU) guidelines on management of male urethral stricture disease.
The panel performed a literature review on these topics covering a time frame between 2008 and 2018, and used predefined inclusion and exclusion criteria for the literature to be selected. Key papers beyond this time period could be included as per panel consensus. A strength rating for each recommendation was added based on a review of the available literature and after panel discussion.
Management of male urethral strictures has extensively been described in literature. Nevertheless, few well-designed studies providing high level of evidence are available. In well-resourced countries, iatrogenic injury to the urethra is one of the most common causes of strictures. Asymptomatic strictures do not always need active treatment. Endoluminal treatments can be used for short, nonobliterative strictures at the bulbar and posterior urethra as first-line treatment. Repetitive endoluminal treatments are not curative. Urethroplasty encompasses a multitude of techniques, and adaptation of the technique to the local conditions of the stricture is crucial to obtain durable patency rates.
Management of male urethral strictures is complex, and a multitude of techniques are available. Selection of the appropriate technique is crucial, and these guidelines provide relevant recommendations.
Injury to the urethra by medical interventions is one of the most common reasons of male urethral stricture disease in well-resourced countries. Although different techniques are available to manage urethral strictures, not every technique is appropriate for every type of stricture. These guidelines, developed based on an extensive literature review, aim to guide physicians in the selection of the appropriate technique(s) to treat a specific type of urethral stricture.
总结 2021 年版欧洲泌尿外科学会（EAU）男性尿道狭窄疾病管理指南。
专家组就这些主题进行了文献回顾，涵盖了 2008 年至 2018 年的时间段，并使用了预先设定的纳入和排除标准来选择文献。根据专家组的共识，可以纳入在此时间范围之外的关键论文。根据对现有文献的审查以及专家组讨论后，为每个建议添加了强度评级。
男性尿道狭窄的管理在文献中有广泛的描述。然而，提供高级别证据的精心设计的研究很少。在资源丰富的国家，医源性尿道损伤是导致狭窄的最常见原因之一。无症状的狭窄并不总是需要积极治疗。腔内治疗可作为一线治疗用于球部和后尿道的短、非闭塞性狭窄。重复腔内治疗不能治愈。尿道成形术包括多种技术，根据狭窄的局部情况调整技术对获得持久通畅率至关重要。
男性尿道狭窄的管理很复杂，有多种技术可供选择。选择合适的技术至关重要，这些指南提供了相关的建议。
在资源丰富的国家，医疗干预导致的尿道损伤是男性尿道狭窄的最常见原因之一。尽管有多种技术可用于治疗尿道狭窄，但并非每种技术都适用于每种类型的狭窄。这些指南是基于广泛的文献回顾制定的，旨在指导医生选择合适的技术来治疗特定类型的尿道狭窄。
