title: Urethral reconstruction in lichen sclerosus.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy. enzo.palminteri@inwind.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Palminteri
authors.forename: Steven B
authors.initials: SB
authors.lastname: Brandes
authors.forename: Miroslav
authors.initials: M
authors.lastname: Djordjevic
mesh_terms: D006801:Humans; D015994:Incidence; D018459:Lichen Sclerosus et Atrophicus / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation; D010030:Ostomy; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012720:Severity of Illness Index; D016038:Skin Transplantation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods