Comparative review of the guidelines for anterior urethral stricture

Purpose We aimed to provide a detailed comparison between the American Urologic Association (AUA), Societe Internationale d'Urologie (SIU), and the European Association of Urology (EAU) guidelines on the evaluation, management, and follow-up of the patients with anterior urethral stricture disease (USD). Methods The urethral stricture guidelines from SUI, AUA, and EAU were collected and evaluated regarding the recommendations on diagnosis, evaluation, and treatment of anterior USD. The strength of evidence for each statement was included and discussed when guidelines differed. Results While the guidelines remarkably align in terms of the diagnostic workup and follow-up, there is discordance in the management of anterior urethral strictures, specifically for the use of endoscopic treatment and stenting. Further, the EAU offers more comprehensive recommendations regarding urethroplasty techniques and patient follow-up. The EAU guidelines are the most recent and first to offer guidance for USD in transgender people and women. Conclusion Reconstructive urology is a rapidly adapting field, and best practices change accordingly. Guideline statements have become more inclusive and expansive but will require further research to improve the level of evidence and continue to provide patients and providers with the best treatment plans.

Automated summary

This study compared the guidelines from the American Urologic Association (AUA), Societe Internationale d'Urologie (SIU), and the European Association of Urology (EAU) on the evaluation, management, and follow-up of patients with anterior urethral stricture disease (USD). The guidelines showed alignment in diagnostic workup and follow-up, but discordance in the management of anterior urethral strictures, particularly for endoscopic treatment and stenting.