Introduction: Urethral stricture disease in males presents a
spectrum of complexity depending on aetiology and location. Inflammatory
strictures and traumatic strictures pose unique challenges. Historically, the
lack of a standardised classification has hindered the comparison of treatment
outcomes and consensus in management.
Aim: To review and describe the major scoring systems
developed for urethral strictures, specifically those arising from inflammatory
and traumatic causes, and to discuss their clinical utility in guiding
management.
Findings: Three principal scoring/classification systems are
in use. The U-score is a numeric composite for anterior strictures based on
stricture length, number, location, and aetiology. The LSE classification is a
standardised staging for anterior urethral strictures, treating stricture
attributes akin to a TNM-like categorisation. The PU-score applies to posterior
strictures, assigning points for injury factors such as aetiology, location,
defect length, and associated complications. Higher scores have been correlated
with more complex surgeries and increased risk of recurrence. The PU-score
likewise predicts surgical complexity and outcomes in posterior injuries.
Conclusion: Scoring systems for urethral strictures help
stratify disease severity and guide management decisions. They facilitate
standardised communication of structural complexity, inform surgical planning
(one-stage vs multi-stage reconstruction), and allow outcome comparisons across
studies. While promising, each system has limitations, and ongoing refinement
and validation are needed before universal adoption in routine practice.
Author(s) Details
Bhavyadeep Korrapati
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Vijayanand Mani
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Vivek Meyyappan
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Velmurugan Palaniyandi
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Hariharasudhan Sekar
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Sriram Krishnamoorthy
Department of Urology and Renal Transplant, Sri Ramachandra
Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-68-8/CH4
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