This study aims to examine the current practice patterns of Japanese urologists in treating male anterior urethral strictures and to compare these results with international trends.
A 16-item questionnaire, adapted from surveys conducted in other countries, was distributed to members of the Japanese Urological Association (JUA) in 2024. Statistical analyses, including Pearson's chi-square test and logistic regression, were performed to identify factors influencing treatment preferences.
We emailed 9898 JUA members, and 1028 (10.4%) responded. 835 (81.2%) handled five or fewer urethral stricture cases annually. While 968 (94.2%) had experience with urethral dilatation, 937 (91.1%) with direct vision internal urethrotomy (DVIU), only 308 (30.0%) had experience with excision and primary anastomosis, and 102 (9.9%) with any oral mucosal graft urethroplasty. For the two hypothetical clinical cases, referring to specialists was selected in 707 (68.8%) and 618 (60.1%), respectively, whereas urethroplasty was chosen in 133 (12.9%) and 243 (23.6%), respectively. Seven hundred seventy-four (75.3%) felt the literature supported going straight to definitive urethroplasty if necessary, and this was significantly associated with being under 50 years of age, holding instructor status, and limiting the indication for DVIU to strictures ≤ 1 cm.
Japanese urologists exhibit limited urethroplasty experience and widely utilize transurethral treatments. The majority of members prefer to refer to a specialist, indicating that, in addition to the difficulty of urethroplasty, making indication decisions is also challenging. It is hoped that evidence-based medical practice will become more widespread.
International journal of urology : official journal of the Japanese Urological Association. 2025 Dec 17 [Epub ahead of print]
Yoshiyuki Ishiura, Sou Kimura, Masayuki Shinchi, Yusuke Hirano, Hiroshi Asanuma, Koji Inoue, Akihiro Kanematsu, Tadashi Tabei, Yoshimi Tamura, Yosuke Nakajima, Kimihiko Moriya, Yusuke Yagihashi, Akio Horiguchi
Department of Urology, Toyama Rosai Hospital, Uozu, Toyama, Japan., Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan., Department of Urology, Keio University School of Medicine, Shinjuku, Tokyo, Japan., Department of Urology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan., Department of Urology, Hyogo Medical University, Nishinomiya, Hyogo, Japan., Department of Urology, Fujisawa Shonandai Hospital, Fujisawa, Kanagawa, Japan., Department of Urology, Shibukawa Medical Center, Shibukawa, Gunma, Japan., Yazawa Clinic, Shibuya, Tokyo, Japan., Department of Pediatric Urology, Jichi Children's Medical Center, Shimotsuke, Tochigi, Japan., Department of Urology, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan., Division of Reconstruction, Center for Trauma, Burn and Tactical Medicine, National Defense Medical College Hospital, Tokorozawa, Saitama, Japan.