title: Current Practice Patterns Among Members of the American Urological Association for Male Genitourinary Lichen Sclerosus.
abstract: OBJECTIVE
  To determine the practice patterns of urologists who treat male genitourinary lichen sclerosus (MGU-LS) via a national web-based survey distributed to American Urological Association members.
  
  
  METHODS
  A 20-question survey was collected from a random sample of American Urological Association members. Respondents answered questions on their practice patterns for MGU-LS diagnosis, treatment of symptomatic urethral stricture disease, surveillance, and follow-up.
  
  
  RESULTS
  In total, 309 urologists completed the survey. The majority of respondents reported practicing more than 20+ years (37.5%) within an academic (31.7%) or group practice (31.1%) setting. The majority of respondents saw 3-5 men with MGU-LS per year (32.7%). The most common locations of MGU-LS involvement included the glans penis (66.2%), foreskin (26.3%), and/or the urethra (5.8%). Respondent first-line treatment for urethral stricture disease was direct visual internal urethrotomy (26.6%) and second-line treatment was referral to subspecialist (38.4%). After controlling for the number of patients evaluated with MGU-LS per year, those with reconstructive training were more likely to perform a primary urethroplasty for men with symptomatic urethral stricture disease (adjusted odds ratio 13.1, 95% confidence interval 5.1-33.8, P < .001). They were also more likely to counsel men on the associated penile cancer risks (adjusted odds ratio 4.6, 95% confidence interval 1.7-12.5, P < .01).
  
  
  CONCLUSIONS
  Reconstructive urologists evaluate the most number of patients with MGU-LS and are more likely to perform primary urethroplasty for urethral stricture disease. Men with MGU-LS should be referred to a reconstructive urologist to understand the full gamut of treatment options.
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco, CA. Electronic address: charles.osterberg@ucsf.edu.
authors.forename: E Charles
authors.initials: EC
authors.lastname: Osterberg
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco, CA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Gaither
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco, CA.
authors.forename: Mohannad A
authors.initials: MA
authors.lastname: Awad
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Amjad
authors.initials: A
authors.lastname: Alwaal
authors.affiliation: Department of Urology, University of Iowa, Iowa, IA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco, CA.
authors.forename: Jack W
authors.initials: JW
authors.lastname: McAninch
authors.affiliation: Department of Urology, University of California-San Francisco, San Francisco, CA.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
mesh_terms: D019538:Health Care Surveys; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D052801:Male Urogenital Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D012955:Societies, Medical; D014481:United States; D014525:Urethral Stricture / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014572:Urology