Lichen Sclerosus and Urethral Stricture Disease
Expert Evaluation and Advanced Reconstruction
Lichen sclerosus (LS) is a chronic inflammatory skin condition that can affect the genital region and, in men, may involve the urethra. When LS causes scarring within the urethra, it can lead to progressive urethral stricture disease that is often recurrent and may require specialized reconstructive care.
Patients with LS-related strictures are frequently referred to Dr. Alex J. Vanni for advanced evaluation and durable surgical management of complex or recurrent disease.
What Is Lichen Sclerosus and How Does It Affect the Urethra?
Lichen sclerosus (LS) is a chronic inflammatory skin condition that most commonly affects the genital and perianal skin in men. When lichen sclerosus involves the urethral lining, it causes progressive scarring and narrowing — known as urethral stricture — that can severely restrict urine flow and significantly impact quality of life.
Lichen sclerosus-associated urethral strictures are among the most challenging conditions in reconstructive urology because the disease is progressive and tends to recur after treatment. Patients with LS strictures frequently require staged reconstruction and long-term follow-up to achieve durable outcomes.
How Does Lichen Sclerosus Cause Urethral Strictures?
In LS, chronic inflammation can lead to fibrosis and narrowing of the urethra. Over time, this may progress from the meatus (urethral opening) inward and can involve longer segments of the urethra.
Because LS is a disease of tissue quality, management differs from many other stricture etiologies. Treatment must account for both the anatomic narrowing (the stricture) and the underlying inflammatory process impacting genital/urethral tissue.
What Are the Symptoms of Lichen Sclerosus Urethral Stricture?
Symptoms overlap with other strictures and may include:
- Weak or spraying stream
- Straining or prolonged urination
- Incomplete emptying
- Recurrent urinary tract infections
- Urinary retention
Some patients also have associated genital skin findings (e.g., whitening, irritation, scarring), although urethral involvement can occur even when skin symptoms are subtle.
How Is Lichen Sclerosus Urethral Stricture Diagnosed?
A thorough evaluation typically includes:
- Focused history and exam (including genital skin assessment when appropriate)
- Urinalysis and culture if infections are suspected
- Imaging/endoscopy to define anatomy (often RUG/VCUG and/or cystoscopy)
- Discussion of prior procedures and recurrence pattern
The most important first step is accurately defining stricture length, location, and tissue quality, since these determine the most durable treatment strategy.
How Is Lichen Sclerosus Urethral Stricture Treated?
Medical and Local Skin Management
LS often benefits from coordinated skin-directed therapy to control inflammation and reduce progression. Your treating team will advise on appropriate medical management.
Endoscopic Treatments (Dilation / DVIU)
These may provide temporary relief in select scenarios, but LS-related strictures often recur, particularly when longer segments are involved.
Definitive Reconstruction: Urethroplasty
Many LS-associated strictures require urethroplasty, with technique tailored to disease extent and tissue condition. Common reconstructive pathways include:
- Buccal mucosa graft urethroplasty for appropriate segments and tissue settings
- Staged urethroplasty for complex disease, compromised tissue, or extensive involvement
- Meatal/fossa navicularis reconstruction when the distal urethra is affected
Your plan should be individualized based on anatomy, prior treatments, and functional goals.
National Referral Center
Patients travel from across the United States for Dr. Vanni's expertise in complex and revision reconstructive urology. His practice is recognized nationally for managing the most challenging cases with consistently excellent outcomes.
Why Experience Matters for LS Stricture Surgery
LS strictures can be among the most challenging forms of urethral stricture disease. Durable outcomes require:
- Precise assessment of extent and progression
- Thoughtful selection of one-stage vs staged reconstruction
- Expertise in redo surgery for recurrent disease
- Long-term follow-up focused on durability and function
Dr. Vanni's practice includes a high volume of lichen sclerosus-associated strictures, with outcomes that reflect careful surgical planning, advanced reconstructive techniques, and long-term commitment to functional results.
Treatment of lichen sclerosus-associated urethral strictures is guided by evidence-based protocols informed by peer-reviewed research on the natural history of the disease and long-term surgical outcomes.
Treatment Outcomes at a Glance
Success Rate
85–95% long-term success with staged reconstruction
Surgery Duration
2–4 hours, often performed in staged procedures
Recovery
Recovery follows standard urethral reconstruction timeline of 4–6 weeks
Have Questions About Lichen Sclerosus Urethral Stricture?
Lichen sclerosus-associated urethral strictures require specialized care and individualized treatment planning. If you have been diagnosed with lichen sclerosus and are experiencing urinary symptoms — or have a history of recurrent urethral strictures — expert evaluation can help determine the most effective path forward.
📖 View Frequently Asked Questions About Urethral Stricture
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If you have lichen sclerosus with urinary symptoms, recurrent strictures, or prior failed treatments, an expert evaluation can clarify the most durable path forward.