Urethral lichen sclerosus under the microscope: A survey of academic pathologists
| Autor: | Bradley Erickson, Tesdahl, B. A., Voznesensky, M. A., Breyer, B. N., Voelzke, B. B., Alsikafi, N. F., Vanni, A. J., Broghammer, J. A., Buckley, J. C., Myers, J. B., Brant, W. O., Zhao, L. C., Smith, T. G., Swick, B. L., Dahmoush, L. |
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| Předmět: |
Male
Urethral Stricture Physicians' Attitude of Health Personnel Biopsy Clinical Sciences Practice Patterns urethral stricture disease Immunohistochemistry Severity of Illness Index United States Pathologists Lichen Sclerosus et Atrophicus Male Urogenital Diseases Health Care Surveys Surveys and Questionnaires genital lichen sclerosus Needle histopathology Humans Urologic Surgical Procedures Genitalia Clinical Competence Retrospective Studies |
| Zdroj: | Scopus-Elsevier The Canadian journal of urology, vol 25, iss 3 Erickson, BA; Tesdahl, BA; Voznesensky, MA; Breyer, BN; Voelzke, BB; Alsikafi, NF; et al.(2018). Urethral lichen sclerosus under the microscope: a survey of academic pathologists. CANADIAN JOURNAL OF UROLOGY, 25(3), 9328-9333. UCSF: Retrieved from: http://www.escholarship.org/uc/item/21s5r4cd |
| Popis: | INTRODUCTION:Given the poor understanding of the pathophysiology of genital lichen sclerosus (GLS) and a lack of accepted definitive diagnostic criteria, we proposed to survey pathologists regarding their understanding of GLS. We hypothesized that significant disagreement about GLS will exist. MATERIALS AND METHODS:All urologists participating in the Trauma and Urologic Reconstruction Network of Surgeons identified genitourinary (GUP) and dermatopathologists (DP) at their respective institutions who were then invited to participate in an online survey regarding their experience with diagnosing GLS, GLS pathophysiology and its relationship to urethral stricture disease. RESULTS:There were 23 (12 DP, 11 GUP) pathologists that completed the survey. The most agreed upon criteria for diagnosis were dermal collagen homogenization (85.7%), loss of the normal rete pattern (33.3%) and atrophic epidermis (28.5%). No pathologists believed GLS had an infectious etiology (19% maybe, 42% unknown) and 19% believed GLS to be an autoimmune disorder (42% maybe, 38% unknown); 19% believed LS to be premalignant, but 52% believed it was associated with cancer; 80% believed that LS could involve the urethra (DP (92%) versus GUP (67%); p = 0.272). Of those diagnosing urethral GLS, 80% of DUP believed that GLS must first involve the glans/prepuce before involving the urethra, while all GUP believed that urethral disease could exist in isolation (p = 0.007). CONCLUSIONS:There was significant disagreement in this specialized cohort of pathologists when diagnosing GLS. A logical first step appears to be improving agreement on how to best describe and classify the disease. This may lead to improve treatments. |
| Databáze: | OpenAIRE |
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