背景:本研究的目的是评估和分析泌尿科医师中男性尿道狭窄疾病(MUSD)的日常临床实践。
方法:考虑到最新的尿道狭窄疾病指南,就男性尿道狭窄疾病不同部位的各种治疗选择和偏好进行了调查。调查通过电子邮件和电话应用程序发送给泌尿科医生。
结果:共有266名泌尿科医师完成了调查,并纳入最终分析。关于工作场所,62(23.3%),58(21.8%),71(26.7%),75名(28.2%)受访者在大学医院工作,培训和研究医院,州立医院,和私人执业医院,分别。关于男性尿道狭窄的诊断方法,88.7%的参与者会选择尿流图+排尿后残留(UF+PVR),64.6%的人会选择逆行尿道造影(RUG)。直视尿道内切开术(DVIU)是阴茎尿道狭窄(PUS)中最常用的方法,72.9%被选中。直视前路内尿道切开术是≤2cm和>2cm狭窄的最常见方法。63.1%,和30.8%,分别。用于增强尿道成形术的最优选移植物是颊粘膜(75.8%)。内镜下切开/切除术(经尿道电切术(TUR))是后尿道/膀胱尿道吻合口狭窄最常用的治疗方法(86.4%)。
结论:本研究清楚地表明,在MUSD中,大多数泌尿科医师仍然更喜欢DVIU和尿道扩张术,这与当前的指导方针相矛盾。应鼓励泌尿科医师进行尿道成形术和/或将患者转诊至有经验的复发性MUSD中心。
BACKGROUND: The aim of the present study is to evaluate and analyze the daily clinical practice for male urethral
stricture disease (MUSD) among urologists.
METHODS: Considering the latest
guidelines on urethral
stricture disease, a survey was developed regarding the various treatment options and preferences in different sites of male urethral
stricture disease. The survey was sent to urologists via e-mail and phone application.
RESULTS: A total of 266 urologists completed the survey and were included in the final analysis. In regard to workplace, 62 (23.3%), 58 (21.8%), 71 (26.7%), and 75 (28.2%) respondents worked in university hospitals, training and research hospitals, state hospitals, and private practice hospitals, respectively. In regard to the diagnostic method used in male urethral strictures, 88.7% of the participants would choose uroflowmetry + postvoiding residual (UF + PVR), and 64.6% would choose retrograde urethrography (RUG). Direct vision internal urethrotomy (DVIU) was the most frequently chosen method in penile urethral strictures (PUS), being chosen by 72.9%. Direct vision anterior internal urethrotomy was the most common method for both ≤2 cm and >2 cm strictures, 63.1%, and 30.8%, respectively. The most preferred graft for augmentation urethroplasty was buccal mucosa (75.8%). Endoscopic incision/resection (transurethral resection (TUR)) is the most frequently applied treatment method for posterior urethral/vesicourethral anastomotic strictures (86.4%).
CONCLUSIONS: The present study clearly shows that most urologists still prefer DVIU and urethral dilatation to urethroplasty in MUSD, which contradicts current
guidelines. Urologists should be encouraged to perform urethroplasty and/or refer patients to experienced centres for recurrent MUSD.