Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200233, China.
BMC Urol. 2021 Dec 31;21(1):185. doi: 10.1186/s12894-021-00950-0.
To investigate the current diagnostic and therapeutic approaches to anterior urethral strictures of Chinese urologists and to compare with developed countries and the American Urologic Association guidelines.
Anonymous questionnaires were distributed to members of Official Wechat Account of urology from March 19, 2020 to April 10, 2020. Descriptive and multiple correspondence analysis were used to analyze the data.
A total of 1276 online questionnaires were received. The response rate was 21.7% (1276/5878). The most common diagnostic methods for anterior urethral stricture were urethrography (90.7%) and urethrocystoscopy (85.4%), while urethral dilation (92.3%) and internal urethrotomy (60.1%) were the main therapeutic procedures. End-to-end urethroplasty (45.2%) was the most common open surgery, followed by skin flap urethroplasty (14.9%) and free graft urethroplasty (12.4%). 76.2% of urologists used urethroplasty only after the failure of minimally invasive surgery (reconstructive ladder treatment strategy). Furthermore, middle-aged or elderly urologists who had attended trainings, had senior practice roles, and who utilized a reconstructive ladder treatment approach were most likely to perform urethroplasties.
Anterior urethral stricture treatment in China is still dominated by minimally invasive surgery, with most urologists using the reconstructive ladder treatment strategy. In general, the overall diagnostic and therapeutic strategies were similar between China and developed countries, with some deviations from the American Urologic Association guidelines.
调查中国泌尿科医生对前尿道狭窄的诊断和治疗方法，并与发达国家和美国泌尿外科学会指南进行比较。
2020 年 3 月 19 日至 4 月 10 日，通过匿名问卷对泌尿外科官方微信公众号的成员进行调查。采用描述性分析和多元对应分析对数据进行分析。
共收到 1276 份在线问卷，应答率为 21.7%（1276/5878）。前尿道狭窄最常见的诊断方法是尿道造影（90.7%）和尿道膀胱镜检查（85.4%），而尿道扩张（92.3%）和尿道内切开术（60.1%）是主要的治疗方法。端端尿道成形术（45.2%）是最常见的开放手术，其次是皮瓣尿道成形术（14.9%）和游离移植物尿道成形术（12.4%）。76.2%的泌尿科医生仅在微创手术失败后才进行尿道成形术（重建阶梯治疗策略）。此外，参加过培训、担任高级实践角色、采用重建阶梯治疗策略的中老年泌尿科医生最有可能进行尿道成形术。
中国前尿道狭窄的治疗仍以微创为主，大多数泌尿科医生采用重建阶梯治疗策略。总体而言，中国与发达国家的整体诊断和治疗策略相似，但与美国泌尿外科学会指南存在一些差异。
