The urological burden of lichen sclerosis: implications for multidisciplinary surveillance and management

Lichen sclerosis (LS) is a chronic inflammatory condition predominantly affecting the anogenital skin, with genitourinary involvement leading to scarring, phimosis, and voiding dysfunction. The long-term urological sequelae, including urological interventions, remain unexplored in large cohorts.

Using the TriNetX database, a retrospective propensity score-matched cohort analysis was conducted, comparing 36,974 patients with LS to 36,974 controls matched by demographics, diabetes mellitus, tobacco use, recurrent urinary tract infections, immunosuppressant use, and prior cystourethroscopy and/or temporary indwelling bladder catheter. Outcomes involved patients with >12 months follow-up with urological complications or urological interventions, identified through ICD-10 codes.

Overall, urethral strictures (relative risk [RR]: 2.256; 95% confidence interval [CI]: 1.753-2.905; P < 0.0001) and urethroplasty (P < 0.0001) rates were significantly elevated in the LS cohort group.

These findings highlight the multisystematic involvement of LS and emphasize the importance for comprehensive dermatologic and urologic follow-up.