Objectives: The management of urethral stricture is often complex and the decision to proceed to urethroplasty may be difficult. A variety of factors are used by urologists to help guide this decision. We sought to conduct a survey to define current management trends and referral patterns in the treatment of urethral stricture disease. Methods: An internet survey was conducted using the email directory for the AUA North Central Section. Survey design focused on urologist demographics and practice type, practice trends for treating urethral strictures, and referral patterns. Results were analyzed to assess for demographic parameters influencing management and referral trends. Results: Responses were received from 84/600 (14%) urologists. Despite 95% of respondents reporting the recent treatment of urethral stricture, the majority of urologists reported performing no urethroplasties within the same time period. Complicated repairs (posterior, buccal) were performed by only a few of the respondents. A variety of factors were used by urologists to help decide at what point urethroplasty should be pursued. However, the importance of these factors varied significantly. Conclusions: Our data suggest that the treatment algorithm for urethral strictures is complex and varies considerably between urologists. The decision to perform urethroplasty may be particularly difficult. Finally, patient referral appears to play a significant role in stricture management. Treatment guidelines based on objective data are needed.

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