MP60-19 EXAMINING THE PATHOPHYSIOLOGY OF URETHRAL STRICTURE DISEASE DUE TO LICHEN SCLEROSUS

Patients affected by a urethral stricture account for a considerable cost to all healthcare systems. The estimated prevalence of all urethral stricture in the UK is 10/100,000 men during youth, increasing to about 40/100,000 by age 65 years and to more than 100/100,000 thereafter. A penile urethral stricture is a narrowing of the lumen of the urethra due to ischaemic fibrosis of the urethral epithelium and/or spongiofibrosis of the corpus spongiosum occurring within the penile urethra. Its aetiology is largely idiopathic but other important causes are failed hypospadias repair and lichen sclerosus, which account for 60% of all cases. Strictures of the anterior urethra account for 92% of cases: bulbar strictures are more frequent (46.9%), followed by penile (30.5%) and combined bulbar/penile (9.9%), that is, 40.4% of all men presenting with stricture will have a penile urethral stricture alone or in combination with a bulbar urethral stricture. There are several options for the treatment of penile urethral strictures ranging from less invasive treatments, including urethral dilatation and direct vision internal urethrotomy, to more complex augmentation graft and flap urethroplasty. The aim of the present review is to describe the aetiology and epidemiology of anterior urethral strictures and the available options reported in literature for their treatment. Level of evidence: 1a

Download Full-text

Evaluation and management of anterior urethral stricture disease

F1000Research ◽

10.12688/f1000research.7121.1 ◽

2016 ◽

Vol 5 ◽

pp. 153 ◽

Cited By ~ 5

Author(s):

Altaf Mangera ◽

Nadir Osman ◽

Christopher R. Chapple

Keyword(s):

Urethral Stricture ◽

Lichen Sclerosus ◽

Long Term Results ◽

Management Options ◽

Urethral Stricture Disease ◽

The Poor ◽

First Recurrence

Urethral stricture disease affects many men worldwide. Traditionally, the investigation of choice has been urethrography and the management of choice has been urethrotomy/dilatation. In this review, we discuss the evidence behind the use of ultrasonography in stricture assessment. We also discuss the factors a surgeon should consider when deciding the management options with each individual patient. Not all strictures are identical and surgeons should appreciate the poor long-term results of urethrotomy/dilatation for strictures longer than 2 cm, strictures in the penile urethra, recurrent strictures, and strictures secondary to lichen sclerosus. These patients may benefit from primary urethroplasty if they have many adverse features or secondary urethroplasty after the first recurrence.

Download Full-text

One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-Analysis

The Journal of Urology ◽

10.1097/ju.0000000000001870 ◽

2021 ◽

Author(s):

Jane T. Kurtzman ◽

Ruth Blum ◽

Steven B. Brandes

Keyword(s):

Systematic Review ◽

Urethral Stricture ◽

Meta Analysis ◽

Lichen Sclerosus ◽

Urethral Stricture Disease ◽

One Stage ◽

Buccal Mucosal Graft

Download Full-text

MP03-09 DESCRIBING THE URINARY MICROBIOME IN PRE-OPERATIVE URINE SPECIMENS OF LICHEN SCLEROSUS INDUCED AND NON-LICHEN SCLEROSUS INDUCED URETHRAL STRICTURE DISEASE

The Journal of Urology ◽

10.1097/ju.0000000000001964.09 ◽

2021 ◽

Vol 206 (Supplement 3) ◽

Author(s):

Amanda Sherman ◽

Travis Sullivan ◽

Harjivan Kohli ◽

Eric Burks ◽

Kimberly Rieger-Christ ◽

...

Keyword(s):

Urethral Stricture ◽

Lichen Sclerosus ◽

Urethral Stricture Disease ◽

Urinary Microbiome ◽

Urine Specimens

Download Full-text

Differential expression of miRNAs involved in biological processes responsible for inflammation and immune response in lichen sclerosus urethral stricture disease

PLoS ONE ◽

10.1371/journal.pone.0261505 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261505

Author(s):

Harjivan Kohli ◽

Brandon Childs ◽

Travis B. Sullivan ◽

Artem Shevtsov ◽

Eric Burks ◽

...

Keyword(s):

Immune Response ◽

Differential Expression ◽

Urethral Stricture ◽

Expression Profiles ◽

Lichen Sclerosus ◽

Differentially Expressed ◽

P Value ◽

Screening Analysis ◽

Urethral Stricture Disease ◽

False Discovery

Purpose To better understand the pathophysiology of lichen sclerosus (LS) urethral stricture disease (USD), we aimed to investigate expression profiles of microRNAs (miRNAs) in tissue samples from men undergoing urethroplasty. Methods Urethral stricture tissue was collected from 2005–2020. Histologic features diagnostic of LS were the basis of pathologic evaluation. Foci of areas diagnostic for LS or non-LS strictures were chosen for RNA evaluation. In an initial screening analysis, 13 LS urethral strictures and 13 non-LS strictures were profiled via miRNA RT-qPCR arrays for 752 unique miRNA. A validation analysis of 23 additional samples (9 LS and 14 non-LS) was performed for 15 miRNAs. Statistical analyses were performed using SPSS v25. Gene Ontology (GO) analysis was performed using DIANA-mirPath v. 3.0. Results In the screening analysis 143 miRNAs were detected for all samples. 27 were differentially expressed between the groups (false discovery p-value <0.01). 15 of these miRNAs individually demonstrated an area under the curve (AUC)>0.90 for distinguishing between between LS and non-LS strictures. 11-fold upregulation of MiR-155-5p specifically was found in LS vs. non-LS strictures (p<0.001, AUC = 1.0). In the validation analysis, 13 of the 15 miRNAs tested were confirmed to have differential expression (false discovery p-value <0.10). Conclusions To our knowledge this is the first study evaluating miRNA expression profiles in LS and non-LS USD. We identified several miRNAs that are differentially expressed in USD caused by LS vs other etiologies, which could potentially serve as biomarkers of LS USD. The top eight differentially expressed miRNAs have been linked to immune response processes as well as involvement in wound healing, primarily angiogenesis and fibrosis.

Download Full-text