{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T19:50:01Z","timestamp":1769284201403,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate whether the management of anterior urethral strictures prior to definitive urethroplasty is appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of a total of 419 men diagnosed with anterior urethral strictures at hospitals across Japan and thereafter referred to our institution for definitive urethroplasty between 2004 and 2019, the medical records of 371, for whom data on stricture characteristics at the initial diagnosis and pre\u2010referral management were available, were retrospectively reviewed. A pre\u2010referral single transurethral procedure, such as direct vision internal urethrotomy or urethral dilation, was considered appropriate only for favorable stricture, defined as a single nontraumatic untreated bulbar urethral stricture \u22642\u00a0cm in size, and repeat transurethral procedures were considered inappropriate in any circumstances. The association between the appropriateness of the pre\u2010referral management strategy and patient and clinical characteristics was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 242 patients (65.2%) had a pre\u2010referral history of at least one transurethral procedure, and performing the procedure was considered inappropriate for 221 patients (59.6%). On multivariate logistic regression analysis, location of the patient's residence far from our institution (outside of the Kanto area; odds ratio 3.35, 95% confidence interval 1.86\u20136.04; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), voiding with intermittent dilation (odds ratio 2.38, 95% confidence interval 1.38\u20134.12; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002), iatrogenic stricture (odds ratio 11.18, 95% confidence interval 5.30\u201323.61; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), and stricture longer than 20\u00a0mm (odds ratio 3.05, 95% confidence interval 1.47\u20136.38; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003) were the independent predictors of inappropriate use of transurethral procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transurethral procedures are often inappropriately used. There is a clear need to promote appropriate management strategies for urethral strictures among general urologists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.14480","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T04:27:18Z","timestamp":1609388838000},"page":"404-409","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Is pre\u2010referral management of anterior urethral strictures prior to urethroplasty appropriate?"],"prefix":"10.1111","volume":"28","author":[{"given":"Kenichiro","family":"Ojima","sequence":"first","affiliation":[{"name":"Department of Urology National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Horiguchi","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Shinchi","sequence":"additional","affiliation":[{"name":"Department of Urology Nishisaitama Chuo National Hospital Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koetsu","family":"Hamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiro","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Urology Nishisaitama Chuo National Hospital Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Urology Nishisaitama Chuo National Hospital Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiko","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Urology National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichi","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery National Defense Medical College Tokorozawa Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.09.009"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.07.087"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.09.011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.01.020"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.08.075"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.12.074"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.10.018"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.08.100"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urpr.2015.07.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.12.035"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.01.013"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.05.004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-020-00638-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2011.01.042"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.11.007"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.09.052"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.10.043"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.03.016"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000128810.86535.be"},{"key":"e_1_2_8_21_1","article-title":"High regional variation in urethroplasty utilization in the United States","author":"Figler B","year":"2014","journal-title":"J. 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