Management of urethral stricture: translating guidelines into clinical practice

Area of Science:

• Urology
• Surgical Practice
• Clinical Guidelines

Background:

• Urethral stricture management has established standards, yet clinical practice varies significantly.
• Understanding adherence to these guidelines among urologists is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the adherence of Turkish urologists to established guidelines for urethral stricture management.
• To identify practice variations in diagnosis and treatment of urethral strictures.

Main Methods:

• An online survey was distributed to members of the Turkish Urological Association.
• Data were collected and analyzed using descriptive statistics to summarize diagnostic and treatment preferences.

Main Results:

• Retrograde urethrography was underutilized (26%), while uroflowmetry (90%) and cystourethroscopy (61%) were common diagnostic tools.
• Blind dilatation with metal bougies (47%) was preferred over other methods, and urethroplasty was infrequently chosen for primary strictures (7%) compared to Direct Vision Internal Urethrotomy (DVIU) (72%).
• Academic urologists demonstrated higher adherence to guideline recommendations, utilizing diagnostic methods and urethroplasty more frequently than their non-academic counterparts.

Conclusions:

• Turkish urologists' management of urethral strictures frequently deviates from current guidelines.
• Underutilization of retrograde urethrography, a preference for metal bougies in dilatation, and the underuse of urethroplasty in favor of repeated DVIU and dilatation characterize current practices.
• Academic urologists appear to follow guideline recommendations more closely than non-academic urologists.