Current opinion in urology · 2026
Lichen sclerosus associated urethral disease: reconstructive strategy and medical adjuncts.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Oszczudłowski Maciej, Białek Lukasz, Dobruch Jakub, Trauma, Reconstructive Urology Working Party of the European Association of Urology Young Academic Urologists
Аннотация
PURPOSE OF REVIEW: Lichen sclerosus associated urethral stricture disease represents a complex and evolving reconstructive challenge due to its heterogeneous presentation, progressive course, and persistent long-term risk of recurrence. This review summarizes contemporary reconstructive strategies and adjunctive therapies, highlighting recent refinements and ongoing limitations in the available evidence.
RECENT FINDINGS: Recent data demonstrate a shift toward single-stage, anatomy-based urethral reconstruction in selected patients with lichen sclerosus, particularly using oral mucosa grafts, while emphasizing the need for segment-specific approaches for distal, penile, and panurethral strictures. Despite these advances, high-quality comparative evidence remains limited, with most studies being retrospective and heterogeneous in design and outcome reporting. A consistent finding across the literature is the clear contraindication to the use of genital skin grafts in lichen sclerosus. Advances in stricture classification systems, outcome assessment tools, and patient-reported measures have improved patient counseling and facilitated more standardized reporting. Topical therapies may play an adjunctive role, whereas systemic treatments remain investigational.
SUMMARY: Management of lichen sclerosus associated urethral stricture disease requires individualized, segment-specific reconstructive strategies and long-term surveillance. While recent refinements support selected single-stage approaches, further prospective, lichen sclerosus specific studies with standardized outcomes are needed to inform evidence-based recommendations.
RECENT FINDINGS: Recent data demonstrate a shift toward single-stage, anatomy-based urethral reconstruction in selected patients with lichen sclerosus, particularly using oral mucosa grafts, while emphasizing the need for segment-specific approaches for distal, penile, and panurethral strictures. Despite these advances, high-quality comparative evidence remains limited, with most studies being retrospective and heterogeneous in design and outcome reporting. A consistent finding across the literature is the clear contraindication to the use of genital skin grafts in lichen sclerosus. Advances in stricture classification systems, outcome assessment tools, and patient-reported measures have improved patient counseling and facilitated more standardized reporting. Topical therapies may play an adjunctive role, whereas systemic treatments remain investigational.
SUMMARY: Management of lichen sclerosus associated urethral stricture disease requires individualized, segment-specific reconstructive strategies and long-term surveillance. While recent refinements support selected single-stage approaches, further prospective, lichen sclerosus specific studies with standardized outcomes are needed to inform evidence-based recommendations.