Objective

To present a summary of the 2021 version of the European Association of Urology (EAU) guidelines on management of male urethral stricture disease.

Evidence acquisition

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.

Evidence synthesis

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.

Conclusions

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.

Patient summary

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.

中文翻译：

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欧洲泌尿外科协会尿道狭窄疾病指南（第 1 部分）：男性尿道狭窄疾病的管理

客观的

概述 2021 年版欧洲泌尿外科协会 (EAU) 男性尿道狭窄疾病管理指南。

取证

专家组对这些主题进行了文献综述，涵盖了 2008 年至 2018 年的时间范围，并使用了预定义的纳入和排除标准来选择文献。根据专家组的共识，可以包括此时间段以外的关键论文。根据对现有文献的回顾和小组讨论，为每项建议添加了强度等级。

证据综合

文献中广泛描述了男性尿道狭窄的处理。然而，提供高水平证据的精心设计的研究很少。在资源充足的国家，尿道的医源性损伤是尿道狭窄最常见的原因之一。无症状的狭窄并不总是需要积极治疗。作为一线治疗，腔内治疗可用于球部和后尿道的短暂、非闭塞性狭窄。重复的腔内治疗不能治愈。尿道成形术包括多种技术，使该技术适应狭窄的局部条件对于获得持久的通畅率至关重要。

结论

男性尿道狭窄的管理很复杂，并且有多种技术可供使用。选择适当的技术至关重要，这些指南提供了相关建议。

患者总结

在资源充足的国家，医疗干预导致的尿道损伤是男性尿道狭窄疾病的最常见原因之一。尽管有不同的技术可用于处理尿道狭窄，但并非每种技术都适用于每种类型的狭窄。这些指南是根据广泛的文献回顾制定的，旨在指导医生选择适当的技术来治疗特定类型的尿道狭窄。