Conservative Management of Penile and Urethral Lichen Sclerosus: A Systematic Review

Christine Shieh, Nizar Hakam, Robert J. Pearce, Meera Nagpal, Umar Ghaffar, José L. Guzman, Behzad Abbasi, Nathan M. Shaw, Charles P. Jones, Benjamin N. Breyer

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Purpose:We evaluate the efficacy and safety profiles of currently available conservative management options for penile and urethral lichen sclerosus.Materials and Methods:A systematic review of existing literature on lichen sclerosus was conducted utilizing the PubMed, Embase, and Web of Science databases. References were assessed for relevance to nonsurgical management of male genital lichen sclerosus by title and abstract by 3 independent reviewers, then reviewed in full and in duplicate by 5 independent reviewers.Results:Seventeen studies describing conservative management of histologically confirmed penile and urethral lichen sclerosus in male patients were included in the final review. We present available evidence supporting the use of 4 major treatment modalities represented in the existing literature: topical corticosteroids, tacrolimus, platelet-rich plasma, and CO2laser. We also briefly discuss the limited studies on the use of oral acitretin and polydeoxyribonucleotide injections. Outcomes assessed include symptoms, clinical appearance, quality of life, sexual satisfaction, adverse effects, and long-term efficacy of treatment.Conclusions:Topical corticosteroids remain the mainstay of conservative management of penile and urethral lichen sclerosus, with current literature supporting the use of other therapies such as tacrolimus and platelet-rich plasma as alternatives or adjuvant treatments when escalation of treatment is necessary. Future research should further explore the efficacy and safety of newer therapies through additional controlled clinical trials in the targeted population.

Original languageEnglish
Pages (from-to)354-363
Number of pages10
JournalJournal of Urology
Volume211
Issue number3
DOIs
StatePublished - Mar 1 2024

Keywords

  • conservative management
  • lichen sclerosus et atrophicus
  • male genital lichen sclerosus
  • urethral stricture

Fingerprint

Dive into the research topics of 'Conservative Management of Penile and Urethral Lichen Sclerosus: A Systematic Review'. Together they form a unique fingerprint.

Cite this