Investig Clin Urol.  2016 May;57(3):202-207. 10.4111/icu.2016.57.3.202.

Diversity of patient profile, urethral stricture, and other disease manifestations in a cohort of adult men with lichen sclerosus

• Kirk PS
• Yi Y
• Hadj-Moussa M
• Malaeb BS

• KMID: 2426495
• DOI: http://doi.org/10.4111/icu.2016.57.3.202

Abstract

PURPOSE
Lichen sclerosus (LS) in men is poorly understood. Though uncommon, it is often severe and leads to repeated surgical interventions and deterioration in quality of life. We highlight variability in disease presentation, diagnosis, and patient factors in male LS patients evaluated at a tertiary care center.
MATERIALS AND METHODS
We retrospectively reviewed charts of male patients presenting to our reconstructive urology clinic with clinical or pathologic diagnosis of LS between 2004 and 2014. Relevant clinical and demographic information was abstracted and descriptive statistics calculated. Subgroup comparisons were made based on body mass index (BMI), urethral stricture, and pathologic confirmation of disease.
RESULTS
We identified 94 patients with clinical diagnosis of LS. Seventy percent (70%) of patients in this cohort had BMI >30 kg/m2, and average age was 51.5 years. Lower BMI patients were more likely to suffer from urethral stricture disease compared to overweight counterparts (p=0.037). Patients presenting with stricture disease were more likely to be younger (p=0.003). Thirty percent (30%) of this cohort had a pathologic diagnosis of LS.
CONCLUSIONS
Urethral stricture is the most common presentation for men with LS. Many patients endure skin scarring and have numerous comorbidities. Patient profile is diverse, raising the concern that not all patients with clinical diagnosis of LS are suffering from identical disease processes. The rate of pathologic confirmation at a tertiary care institution is alarmingly low. Our findings support a role for increased focus on pathologic confirmation and further delineation of the subtype of disease based on location and clinical manifestations.

Keyword

Balanitis xerotica obliterans; Lichen sclerosus et atrophicus; Urethral stricture

MeSH Terms

Adult
Age Factors
Aged
Body Mass Index
Cohort Studies
Humans
Lichen Sclerosus et Atrophicus/*complications/*diagnosis/pathology
Male
Middle Aged
Retrospective Studies
Risk Factors
Urethral Stricture/*etiology/pathology

Figure

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  Fig. 1 Distribution of body mass index in male Lichen sclerosus patients.

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