Radiation therapy (RT) in the management of pelvic cancers remains a clinical challenge to urologists given the sequelae of urethral stricture disease secondary to fibrosis and vascular insults. The objective of this review is to understand the physiology of radiation-induced stricture disease and to educate urologists in clinical practice regarding future prospective options clinicians have to deal with this condition. The management of post-radiation urethral stricture consists of conservative, endoscopic, and primary reconstructive options. Endoscopic approaches remain an option, but with limited long-term success. Despite concerns with graft take, reconstructive options such as urethroplasties in this population with buccal grafts have shown long-term success rates ranging from 70 to 100%. Robotic reconstruction is augmenting previous options with faster recovery times. Radiation-induced stricture disease is challenging with multiple interventions available, but with successful outcomes demonstrated in various cohorts including urethroplasties with buccal grafts and robotic reconstruction.
Journal of clinical medicine. 2023 Jun 09*** epublish ***
Joshua Sterling, Syed N Rahman, Ajin Varghese, Javier C Angulo, Dmitriy Nikolavsky
Yale School of Medicine, 20 York Street, New Haven, CT 06511, USA., New York College of Osteopathic Medicine, 8000 Old Westbury, Glen Head, NY 11545, USA., Faculty of Biomedical Sciences, Universidad Europea, 28905 Madrid, Spain., SUNY Upstate Medical College, Syracuse, NY 13210, USA.