Medical Management of Penile and Urethral Lichen Sclerosus with Topical Clobetasol Improves Long-Term Voiding Symptoms and Quality of Life

No AccessJournal of UrologyAdult Urology1 Dec 2020Medical Management of Penile and Urethral Lichen Sclerosus with Topical Clobetasol Improves Long-Term Voiding Symptoms and Quality of Life Joshua P. Hayden, William R. Boysen, and Andrew C. Peterson Joshua P. HaydenJoshua P. Hayden *Correspondence: Duke University School of Medicine telephone: 603-903-4839; email: E-mail Address: [email protected] Duke University School of Medicine, Durham, North Carolina , William R. BoysenWilliam R. Boysen Department of Surgery, Division of Urology, Duke University Medical Center, Durham, North Carolina , and Andrew C. PetersonAndrew C. Peterson *Division of Urology, Duke University Medical Center, Durham, North Carolina 27710 E-mail Address: [email protected] Department of Surgery, Division of Urology, Duke University Medical Center, Durham, North Carolina View All Author Informationhttps://doi.org/10.1097/JU.0000000000001304AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the success of minimally invasive management of lichen sclerosus with topical and intraurethral clobetasol, as defined by improvement in patient reported outcome measures and nonprogression to surgery. Materials and Methods: We conducted a review of our prospective ongoing quality improvement study to determine outcomes of our current standard practice for males with penile and urethral biopsy proven lichen sclerosus. Data were collected between 2011 and 2019, and included patient demographic information, medical and surgical histories, and location and extent of lichen sclerosus related pathology. The primary outcomes for this study were voiding function and voiding related quality of life, and were assessed using the AUASS (American Urological Association Symptom Score) and quality of life bother index, respectively. Results: We identified 42 patients with biopsy proven lichen sclerosus related urethral stricture disease. Of these patients 85.7% were treated with intraurethral steroids alone and did not require surgical intervention. Median AUASS significantly improved from 12 to 8, and median quality of life bother index improved from 4 ("mostly dissatisfied") to 2 ("mostly satisfied"). Average stricture length of those with penile urethral disease and bulbar urethral disease was 4.8 cm (SD 3.0) and 16.2 cm (SD 6.5), respectively. Median followup was 8.4 months (IQR 2.6–26.4). 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Editor's Note: This article is the fourth of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1391 and 1392. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 204Issue 6December 2020Page: 1290-1295 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordslichen sclerosus et atrophicusclobetasolurethral stricturebalanitis xerotica obliteransMetricsAuthor Information Joshua P. Hayden Duke University School of Medicine, Durham, North Carolina *Correspondence: Duke University School of Medicine telephone: 603-903-4839; email: E-mail Address: [email protected] More articles by this author William R. Boysen Department of Surgery, Division of Urology, Duke University Medical Center, Durham, North Carolina More articles by this author Andrew C. Peterson Department of Surgery, Division of Urology, Duke University Medical Center, Durham, North Carolina *Division of Urology, Duke University Medical Center, Durham, North Carolina 27710 E-mail Address: [email protected] Financial interest and/or other relationship with Boston Scientific. More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the fourth of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1391 and 1392. Advertisement PDF DownloadLoading ...