Insights into the Pathophysiology of Urethral Stricture Disease due to Lichen Sclerosus: Comparison of Pathological Markers in Lichen Sclerosus Induced Strictures vs Nonlichen Sclerosus Induced Strictures

Levy, Alison; Browne, Brendan; Fredrick, Ariel; Stensland, Kristian; Bennett, Jennifer A.; Sullivan, Travis; Rieger-Christ, Kimberly; Vanni, Alex J.

doi:10.1097/ju.0000000000000155

Cited by 23 publications

(14 citation statements)

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“…Alterations to a cell's microenvironment by local bacteria may explain the pathway between inflammation and cancer development [23]. Efforts to identify unique protein expression profiles of LS are underway, but the microbiome itself may be a potential biomarker [13,24]. Given the complexity and potential morbidity in obtaining a tissue diagnosis of LS in the urethra, using urine as a microbial-based biomarker would be advantageous.…”

Section: Resultsmentioning

confidence: 99%

“…In our cohort, we did not find evidence of this bacterium for patients in the LS-USD group. There is alternative evidence of a viral cause of LS [13]. Additionally, how microbiota may inform patients' USD symptomatology or affect surgical repair is an open question.…”

Section: Resultsmentioning

confidence: 99%

“…USD incurs substantial morbidity and incurs high costs in affected men [12]. Infectious etiologies have been suggested as causative agents for LS [13]. Explorations of the urinary microbiome may shed light into the pathophysiology of this complex disease.…”

Section: Introductionmentioning

confidence: 99%

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Synchronous genitourinary lichen sclerosus signals a distinct urinary microbiome profile in men with urethral stricture disease

et al. 2020

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Purpose Alterations in the urinary microbiome have been associated with urological diseases. The microbiome of patients with urethral stricture disease (USD) remains unknown. Our objective is to examine the microbiome of USD with a focus on inflammatory USD caused by lichen sclerosus (LS). Methods We collected mid-stream urine samples from men with LS-USD (cases; n = 22) and non-LS USD (controls; n = 76). DNA extraction, PCR amplification of the V4 hypervariable region of the 16S rRNA gene, and sequencing was done on the samples. Operational taxonomic units (OTUs) were defined using a > 97% sequence similarity threshold. Alpha diversity measurements of diversity, including microbiome richness (number of different OTUs) and evenness (distribution of OTUs) were calculated and compared. Microbiome beta diversity (difference between microbial communities) relationships with cases and controls were also assessed. Results Fifty specimens (13 cases and 37 controls) produced a 16S rRNA amplicon. Mean sample richness was 25.9 vs. 16.8 (p = 0.076) for LS-USD vs. non-LS USD, respectively. LS-USD had a unique profile of bacteria by taxonomic order including Bacillales, Bacteroidales and Pasteurellales enriched urine. The beta variation of observed bacterial communities was best explained by the richness. Conclusions Men with LS-USD may have a unique microbiologic richness, specifically inclusive of Bacillales, Bacteroidales and Pasteurellales enriched urine compared to those with non-LS USD. Further work will be required to elucidate the clinical relevance of these variations in the urinary microbiome.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Synchronous genitourinary lichen sclerosus signals a distinct urinary microbiome profile in men with urethral stricture disease

et al. 2020

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“…Insgesamt sind die Fallzahlen der vorliegenden Arbeiten relativ niedrig, sodass primär auf die relevanten Ätiologien eingegangen wird. Hinsichtlich weiterer Erkrankungen, die im Verlauf zur pathognomonischen Harnröhrenstriktur führen können werden die Urogenitaltuberkulose [18], Lichen sclerosus [19], Harnröhrenkarzinome [20,21] oder Harnröhrenpolypen [22] genannt.…”

Section: äTiologie Und Pathophysiologie Der Weiblichen Harnröhrenerkrankungenunclassified

Harnröhrenstrikturen der Frau: Aktuelles zu Diagnostik und Therapie

2021

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ZusammenfassungHarnröhrenstrikturen der Frau sind ein seltenes Krankheitsbild mit individueller Symptomatik. Vor diesem Hintergrund mangelt es an klinischen Leitfäden, die sich mit Diagnostik und Therapie dieser Erkrankung befassen. Mittlerweile liegen einige Ergebnisse zu verschiedenen Operationstechniken vor, ein direkter inter-institutioneller Vergleich wird jedoch durch heterogene Patientenkohorten und kleine Fallzahlen erschwert. Die vorliegende Arbeit befasst sich mit einer aktuellen narrativen Literaturübersicht relevanter Artikel zur klinischen Diagnostik und zu den Therapiemöglichkeiten bei weiblicher Harnröhrenstriktur.Iatrogene Ursachen wie eine vorangegangene Katheterisierung oder ein urogenitaler operativer Eingriff sind die häufigsten Gründe für die Entstehung einer Harnröhrenstriktur bei der Frau. Im klinischen Alltag stellt die körperliche Untersuchung einen wichtigen Grundstein in der Differentialdiagnostik dar, um bei Verdacht auf eine anatomisch-morphologische Ursache der Harnblasenentleerungsstörung weitere diagnostische Maßnahmen (Urethrozystoskopie, Urethrographie, MRT) einzuleiten. Therapeutisch sind minimal-invasive Eingriffe wie Harnröhrenbougierungen oder Urethrotomien oftmals nur mit kurzfristigem Erfolg assoziiert, sodass die offene Harnröhrenrekonstruktion mit langfristigeren Therapieerfolgen hier eine Sonderstellung einnimmt. Zur Verfügung stehen neben offenen Harnröhrenplastiken mit gestielten Lappen aus Vaginal- oder Labialschleimhaut auch die Verwendung freier Transplantate, vor allem dem Mundschleimhaut-Autotransplantat. Aufgrund der genannten Seltenheit der Erkrankung mit nur kleinen publizierten Fallserien ist jedoch eine Beurteilung der vergleichenden Wirksamkeit der verschiedenen Techniken nur schwer möglich. Wie bei allen seltenen Erkrankungen bedarf es hier der Etablierung von multizentrischen, großen Serien, um die Standards im perioperativen Vorgehen zu verbessern.

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“…Inflammatory urethral strictures can be differentiated from other strictures by other etiologies by being observed in the anterior part of the urethra only and also by being more longer than other types of strictures. 2,10 Treatment and post-treatment recurrence Although many approaches have been previously reported for the different types of urethral strictures, these disorders can be complicated by recurrence in the following post-treatment period. It should be noted that the management of urethral strictures is mainly based on the presence of complications.…”

Section: Types Of Urethral Stricturesmentioning

confidence: 99%

Types of urethral stricture and their recurrence rates post urological treatments

Basaif

Alamri²,

Mousa

et al. 2021

Int J Community Med Public Health

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Urethral strictures can significantly impact the quality of life for patients because it can be associated with significant complications such as fistulas, bladder calculi, infections and sepsis. Additionally, it might even lead to renal failure. The worldwide prevalence of urethral strictures is high, with an estimated rate of 229-627 patients per 100,000 population. In this literature review, the aim was to discuss the types and etiology of urethral strictures and the recurrence rates following the different management modalities. Studies that were included in this review were published between January 2005 until May 2021. The results support the current evidence that the idiopathic and iatrogenic bulbar strictures are the most common types while penile strictures, the iatrogenic and inflammatory are the most common causes. Recurrence rates are reported after management with almost all of the current management modalities, indicating the need for better interventions to enhance the outcomes and alleviate the quality of care. The recurrence rate of strictures after treatment with internal urethrotomy and direct vision internal urethrotomy by three years is 65%. Other studies reported that the rate of recurrence was estimated to be around 14 after 6 months from internal urethrotomy and up to 27% after 12 months. The rate of complications and recurrence following treatment with anastomotic urethroplasty was estimated to be less than 5%. Detailed information and discussion were provided in the study manuscript.

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Insights into the Pathophysiology of Urethral Stricture Disease due to Lichen Sclerosus: Comparison of Pathological Markers in Lichen Sclerosus Induced Strictures vs Nonlichen Sclerosus Induced Strictures

Cited by 23 publications

References 0 publications

Synchronous genitourinary lichen sclerosus signals a distinct urinary microbiome profile in men with urethral stricture disease

Synchronous genitourinary lichen sclerosus signals a distinct urinary microbiome profile in men with urethral stricture disease

Harnröhrenstrikturen der Frau: Aktuelles zu Diagnostik und Therapie

Types of urethral stricture and their recurrence rates post urological treatments

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