Introduction: Treatment methods of anterior urethral strictures in adults have undergone considerable changes in the recent past. Our goal was to determine national practice patterns among German urologists and to compare results with the results of prior international surveys. Methods: We conducted a survey on the management of urethral strictures among German urologists. Results: Eight hundred forty-five urologists, representing about 14.6% of German urologists, answered the survey. Most common procedures were direct vision internal urethrotomy (DVIU; 87.2%), blind internal urethrotomy (57.5%), dilatation (56.3%), ventral buccal mucosa graft urethroplasty (31.6%) and excision and primary anastomosis (28.9%). In case of a 3.5-cm bulbar stricture and in the case of a 1-cm bulbar stricture after 2 failed DVIUs, a consecutive urethroplasty was significantly more often favoured compared to transurethral treatment options (44.9 vs. 21.3% and 59.4 vs. 8.3%, both p < 0.001). Conclusion: Open urethral reconstruction reveals to be a more common method in practice nowadays. Adherence to recommended treatment algorithms improved in comparison to prior surveys.

1.
Santucci RA, Joyce GF, Wise M: Male urethral stricture disease. J Urol 2007;177:1667-1674.
2.
Mundy AR, Andrich DE: Urethral strictures. BJU Int 2011;107:6-26.
3.
Latini JM, McAninch JW, Brandes SB, Chung JY, Rosenstein D: SIU/ICUD consultation on urethral strictures: epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries. Urology 2014;83(3 suppl):S1-S7.
4.
Chapple C, Andrich D, Atala A, Barbagli G, Cavalcanti A, Kulkarni S, et al: SIU/ICUD consultation on urethral strictures: the management of anterior urethral stricture disease using substitution urethroplasty. Urology 2014;83(3 suppl):S31-S47.
5.
Wessells H, Angermeier KW, Elliott S, Gonzalez CM, Kodama R, Peterson AC, Reston J, et al: Male Urethral Stricture: American Urological Association Guideline. J Urol 2017;197:182-190.
6.
Buckley JC, Heyns C, Gilling P, Carney J: SIU/ICUD consultation on urethral strictures: dilation, internal urethrotomy, and stenting of male anterior urethral strictures. Urology 2014;83(3 suppl):S18-S22.
7.
Wright JL, Wessells H, Nathens AB, Hollingworth W: What is the most cost-effective treatment for 1 to 2-cm bulbar urethral strictures: societal approach using decision analysis. Urology 2006;67:889-893.
8.
Mangera A, Patterson JM, Chapple CR: A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures. Eur Urol 2011;59:797-814.
9.
Barbagli G, Guazzoni G, Lazzeri M: One-stage bulbar urethroplasty: retrospective analysis of the results in 375 patients. Eur Urol 2008;53:828-833.
10.
Pansadoro V, Emiliozzi P: Internal urethrotomy in the management of anterior urethral strictures: long-term followup. J Urol 1996;156:73-75.
11.
Santucci R, Eisenberg L: Urethrotomy has a much lower success rate than previously reported. J Urol 2010;183:1859-1862.
12.
Steenkamp JW, Heyns CF, de Kock ML: Internal urethrotomy versus dilation as treatment for male urethral strictures: a prospective, randomized comparison. J Urol 1997;157:98-101.
13.
Bullock TL, Brandes SB: Adult anterior urethral strictures: a national practice patterns survey of board certified urologists in the United States. J Urol 2007;177:685-690.
14.
van Leeuwen MA, Brandenburg JJ, Kok ET, Vijverberg PL, Bosch JL: Management of adult anterior urethral stricture disease: nationwide survey among urologists in the Netherlands. Eur Urol 2011;60:159-166.
15.
Palminteri E, Maruccia S, Berdondini E, Di Pierro GB, Sedigh O, Rocco F: Male urethral strictures: a national survey among urologists in Italy. Urology 2014;83:477-484.
16.
Morey AF, Watkin N, Shenfeld O, Eltahawy E, Giudice C: SIU/ICUD consultation on urethral strictures: anterior urethra - primary anastomosis. Urology 2014;83(3 suppl):S23-S26.
17.
Lacy JM, Cavallini M, Bylund JR, Strup SE, Preston DM: Trends in the management of male urethral stricture disease in the veteran population. Urology 2014;84:1506-1509.
18.
Xu YM, Song LJ, Wang KJ, Lin J, Sun G, Yue ZJ, et al: Changing trends in the causes and management of male urethral stricture disease in China: an observational descriptive study from 13 centres. BJU Int 2015;116:938-944.
19.
Barbagli G, Palminteri E, Lazzeri M, Guazzoni G, Turini D: Long-term outcome of urethroplasty after failed urethrotomy versus primary repair. J Urol 2001;165(6 pt 1):1918-1919.
20.
Heyns CF, Steenkamp JW, De Kock ML, Whitaker P: Treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful? J Urol 1998;160:356-358.
21.
Greenwell TJ, Castle C, Andrich DE, MacDonald JT, Nicol DL, Mundy AR: Repeat urethrotomy and dilation for the treatment of urethral stricture are neither clinically effective nor cost-effective. J Urol 2004;172:275-277.
22.
Mundy AR: Words of wisdom. Re: outcome of dorsal buccal graft urethroplasty for recurrent urethral strictures. Eur Urol 2009;55:991-992.
23.
Fossati N, Barbagli G, Larcher A, Dell'Oglio P, Sansalone S, Lughezzani G, et al: The surgical learning curve for one-stage anterior urethroplasty: a prospective single-surgeon study. Eur Urol 2016;69:686-690.
24.
Rapp DE, Chanduri K, Infusino G, Hoda ZA, Orvieto MA, Elliott SP, et al: Internet survey of management trends of urethral strictures. Urol Int 2008;80:287-290; discussion 290-291.
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