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Urethral reconstruction in lichen sclerosus

Palminteri, Enzoa; Brandes, Steven B.b; Djordjevic, Miroslavc

doi: 10.1097/MOU.0b013e328358191c
URETHRAL RECONSTRUCTION: Edited by Margit Fisch
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Purpose of review Lichen sclerosus is a chronic skin disease that shows a predilection for the anogenital area and may involve anterior urethra causing stenosis. Surgical options in the management of urethral strictures caused by lichen sclerosus still represent a challenging issue.

Recent findings Depending on the length and severity of urethral involvement, surgical management of lichen sclerosus urethral strictures can range from a simple meatotomy to a single or complex staged long repair using oral mucosa. Skin grafts or flaps are not recommended because skin could be involved by the disease. Perineal urethrostomy may represent the salvage solution in severe panurethral strictures.

Summary One-stage or staged repairs using oral mucosa grafts are the most recommended procedures for the treatment of lichen sclerosus urethral strictures, but derivative perineal urethrostomy may play an important role in severe situations. Patients require long-term follow-up and extensive counseling that enables them to fully grasp the chronic and progressive nature of the disease and to deal with it.

aCenter for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy

bWashington University School of Medicine, Saint Louis, Missouri, USA

cDepartment of Urology, University of Belgrade, Belgrade, Serbia

Correspondence to Enzo Palminteri, Center for Urethral Surgery, Via Dei Lecci 22, 52100 Arezzo, Italy. Tel: +39 338 6841527; e-mail: enzo.palminteri@inwind.it

© 2012 Lippincott Williams & Wilkins, Inc.