Ask AI

Library

Updates

Table of contents

Urethral stricture

What's new

Updated 2024 EAU guidelines for the diagnosis and management of urethral strictures.

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of urethral stricture are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2024), the American Urological Association (AUA 2023,2014), the Canadian Urological Association (CUA 2020), and the World Society of Emergency Surgery (WSES/AAST 2019).
1
2
3
4
5

Classification and risk stratification

Severity assessment
As per EAU 2024 guidelines:
Use a validated patient-reported outcome measure to assess symptom severity and impact on the QoL in patients undergoing surgery for urethral stricture.
A
Use a validated tool to assess sexual function in male patients undergoing surgery for urethral stricture.
A
Create free account

Diagnostic investigations

Initial evaluation: as per EAU 2024 guidelines, obtain uroflowmetry and estimation of postvoid residual in patients with suspected urethral stricture.
A
Create free account

More topics in this section

  • Diagnostic imaging

Medical management

Conservative management
As per EAU 2024 guidelines:
Do not perform an intervention in patients with asymptomatic incidental (> 16 Fr) urethral strictures.
D
Consider offering long-term suprapubic catheterization in patients with radiation-induced bulbomembranous strictures and/or poor performance status.
C
Create free account

Therapeutic procedures

Intraurethral/intralesional injections
As per EAU 2024 guidelines:
Administer intraurethral corticosteroids, in addition to intralesional corticosteroids, to stabilize the urethral stricture.
B
Administer intralesional injections only in the context of a clinical trial.
B
Create free account

Perioperative care

Preoperative urethral rest: as per AUA 2023 guidelines, consider placing a suprapubic cystostomy to promote "urethral rest" before definitive urethroplasty in patients dependent on an indwelling urethral catheter or intermittent self-dilation.
C
Create free account

More topics in this section

  • Intraoperative antibiotic prophylaxis

  • Postoperative catheter removal

Surgical interventions

Timing for surgery: as per EAU 2024 guidelines, do not perform urethroplasty within 3 months of any form of urethral manipulation.
D
Create free account

More topics in this section

  • Endoluminal management (indications)

  • Endoluminal management (technical considerations)

  • Endoluminal management (postoperative care)

  • Urethroplasty (bulbar strictures)

  • Urethroplasty (meatal stenosis or fossa navicularis/penile strictures)

  • Urethroplasty (panurethral urethral reconstruction)

  • Urethroplasty (tissue grafts)

  • Perineal urethrostomy

  • Cystectomy and urinary diversion

Specific circumstances

Patients with traumatic urethral injury, monitoring: as per AUA 2014 guidelines, monitor patients for stricture formation for at least one year after urethral injury.
B
Create free account

More topics in this section

  • Patients with traumatic urethral injury (evaluation)

  • Patients with traumatic urethral injury (management)

  • Patients with radiation-induced strictures

  • Patients with lichen sclerosus-related strictures

  • Patients with strictures after prostatic interventions

  • Patients with strictures after hypospadias repair

  • Patients requiring chronic self-catheterization

  • Female patients (evaluation)

  • Female patients (urethral dilation)

  • Female patients (urethroplasty)

  • Transgender patients

Patient education

General counseling: as per EAU 2024 guidelines, counsel about safe sexual practices, educate about symptoms of STIs, and provide access to prompt investigation and treatment in male patients with urethritis.
A
Create free account

Follow-up and surveillance

Follow-up: as per EAU 2024 guidelines, obtain cystoscopy or retrograde urethrography to assess anatomic success after urethroplasty surgery.
B
Show 2 more
Create free account

More topics in this section

  • Management of recurrent strictures

Quality improvement

Requirements for urinary catheterization: as per EAU 2024 guidelines, avoid performing unnecessary urethral catheterization.
D
Show 4 more
Create free account