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2023 UPDATE - Canadian Urological Association guideline: Management of cystic renal lesions Prior to original publication (March 2017), this guideline underwent review by the CUA Guidelines Committee, CUA members at large, and the CUA Executive Board. The 2023 updates were app roved by the CUA Guidelines Committee and CUA Executive Board.

ABSTRACT:

SUBMITTER: Richard PO

PROVIDER: S-EPMC10263289 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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2023 UPDATE - Canadian Urological Association guideline: Management of cystic renal lesions Prior to original publication (March 2017), this guideline underwent review by the CUA Guidelines Committee, CUA members at large, and the CUA Executive Board. The 2023 updates were app roved by the CUA Guidelines Committee and CUA Executive Board.

Richard Patrick O PO Violette Philippe D PD Bhindi Bimal B Breau Rodney H RH Gratton Matthieu M Jewett Michael A S MAS Kapoor Anil A Pouliot Frederic F Leveridge Michael M So Alan I AI Whelan Tom F TF Rendon Ricardo A RA Tanguay Simon S Finelli Antonio A

Canadian Urological Association journal = Journal de l'Association des urologues du Canada 20230601 6

PMID: 37310905

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Project description:Urethral stricture is fundamentally a fibrosis of the urethral epithelial and associated corpus spongiosum, which in turn, causes obstruction of the urethral lumen. Patients with urethral stricture most commonly present with lower urinary tract symptoms, urinary retention or urinary tract infection but may also experience a broad spectrum of other signs and symptoms, including genitourinary pain, hematuria, abscess, ejaculatory dysfunction, or renal failure. When urethral stricture is initially suspected based on clinical assessment, cystoscopy is suggested as the modality that most accurately establishes the diagnosis. This recommendation is based on several factors, including the accuracy of cystoscopy, as well as its wide availability, lesser overall cost, and comfort of urologists with this technique. When recurrent urethral stricture is suspected, we suggest performing retrograde urethrography to further stage the length and location of the stricture or referring the patient to a physician with expertise in reconstructive urology. Ultimately, the treatment decision depends on several factors, including the type and acuity of patient symptoms, the presence of complications, prior interventions, and the overall impact of the urethral stricture on the patient's quality of life. Endoscopic treatment, either as dilation or internal urethrotomy, is suggested rather than urethroplasty for the initial treatment of urethral stricture. This recommendation applies to men with undifferentiated urethral stricture and does not apply to trauma-related urethral injuries, penile urethral strictures (hypospadias, lichen sclerosus), or suspected urethral malignancy. In the setting of recurrent urethral stricture, urethroplasty is suggested rather than repeat endoscopic management but this may vary depending on patient preference and impact of the symptoms on the patient.The purpose of this guideline is to provide a practical summary outlining the diagnosis and treatment of urethral stricture in the Canadian setting.

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