J Midlife Health 2017 Apr-Jun;8(2):55-62

Department of Dermatology and Venereology, Pramukshwami Medical College, Karamsad, Gujarat, India.

Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Read More

Dermatol Online J 2017 06 15;23(6). Epub 2017 Jun 15.

Department of Dermatology, Hospital Santa Casa de Curitiba, Curitiba, Paraná, Brazil.

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis, characterized by shiny, atrophic, hypochromic papules with a predilection for the genital and perineal skin. Extragenital involvement may occur, but is rare in the isolated form. LSA more commonly affects prepubertal and postmenopausal women. Read More

JAMA Dermatol 2017 May 24. Epub 2017 May 24.

Division of Dermatology, Washington University School of Medicine, St Louis, Missouri.

Klin Padiatr 2017 Jul 2;229(4):247-248. Epub 2017 May 2.

Klinik für Hautkrankheiten, Universitatsklinikum Jena, Jena.

An Bras Dermatol 2016 Sep-Oct;91(5 suppl 1):81-83

Clinical Center of Serbia, Faculty of Medicine, University of Belgrade - Belgrade, Serbia.

Lichen sclerosus et atrophicus is a chronic disease of unknown etiology characterized by atrophic and sclerotic plaques in both genital and extragenital regions. Extensive bullous lichen sclerosus et atrophicus (BLSA) is a severe variant of the disease with no widely accepted treatment. We present a 63-year-old woman with extensive extragenital, ivory-colored, atrophic plaques on her trunk and extremities and disseminated hemorrhagic bullae. Read More

Pan Afr Med J 2016 24;25:190. Epub 2016 Nov 24.

Service de Dermatologie, CHU Ibn Sina Rabat, Maroc.

Lichen sclerosus et atrophicus is a chronic inflammatory dermatosis, characterized by a specific external genital mucosal tissue tropism. Isolated cutaneous manifestation is rare. We report a case of lichen sclerosus et atrophicus in a woman with purely cutaneous involvement, in order to highlight the importance of evoking this diagnosis in the absence of obvious genital involvement. Read More

J Urol 2017 Mar 10. Epub 2017 Mar 10.

Department of Urology, Shanghai Jiaotong University Affiliated Sixth People's Hospital and Shanghai Eastern Urological Reconstruction and Repair Institute, Shanghai, China; Department of Urology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

Purpose: We evaluated outcomes and donor site complications in male patients with complex urethral strictures who underwent urethroplasty using with long strip oral mucosal grafts. We also analyzed whether a lingual mucosa graft is a good substitute for repairing long segment urethral strictures.

Materials And Methods: This retrospective study was done in 81 male patients with complex urethral strictures who underwent oral mucosal graft urethroplasty. Read More

Int J Dermatol 2017 May 27;56(5):589-591. Epub 2017 Feb 27.

Center of Aesthetic Medicine, Department of Dermatology, Medical University Graz, Graz, Austria.

Background: The use of special silk textiles (Dermasilk) has shown positive effects on chronic inflammatory diseases like lichen sclerosus et atrophicus, atopic dermatitis, diabetic ulcerations, and vulvovaginal candidiasis.

Objective: Wearing T-shirts of this particular fabric could be useful in the management of patients with acne vulgaris on the back and trunk.

Material And Methods: Dermasilk T-shirts were given to 14 patients with acne vulgaris papulopustulosa on the back. Read More

Indian Dermatol Online J 2017 Jan-Feb;8(1):57-59

Department of Dermatology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.

Int J Cancer 2017 May 10;140(9):1998-2002. Epub 2017 Feb 10.

Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.

Malignant potential of lichen sclerosus (LS) has been suspected, but evidence is sparse. We used the population-based Finnish Cancer Registry data to further study this connection. We identified all women with the diagnosis of LS (n = 7,616) listed in the Finnish Hospital Discharge Registry from 1970 to 2012. Read More

J Am Acad Dermatol 2017 Feb;76(2S1):S49-S51

Institute of Dermatology, Catholic University, Rome, Italy. Electronic address:

J Pediatr Urol 2017 Apr 9;13(2):208.e1-208.e4. Epub 2016 Dec 9.

Alder Hey Children's NHS Foundation Trust, Department of Paediatric Surgery, E Prescot Rd, Liverpool, L14 5AB, UK.

Introduction: Over 27,000 circumcisions were performed in England in 2012-13. The complication rate is generally perceived to be low, although published figures vary widely. Balanitis xerotica obliterans, more correctly termed Lichen Sclerosus et atrophicus (LS), is one of the commonest indications for medical circumcision. Read More

G Ital Dermatol Venereol 2017 02;152(1):92-94

Infectious Dermatology and Allergology Unit (STI/HIV Unit), San Gallicano Dermatologic Institute, IRCCS, Rome, Italy -

G Ital Dermatol Venereol 2017 02;152(1):83-84

Department of Dermatology, Umberto I Polyclinic, Sapienza University, Rome, Italy.

J Cosmet Laser Ther 2017 Apr 2;19(2):106-108. Epub 2017 Feb 2.

a Dermatology Department , Clínica Dermitek , Bilbao , Spain.

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory disease of unknown cause that typically affects the genital area (1). It has been reported in post-traumatic areas as a result of Koebner phenomenon. LSA responds poorly to treatment making it a therapeutic challenge (2). Read More

Urol Clin North Am 2017 Feb;44(1):77-86

Division of Urology, Department of Surgery, Duke University Medical Center, DUMC 3146, Durham, NC 27710, USA.

Lichen sclerosis (LS) is a chronic, relapsing disease with a variable presentation. In men, genitourinary LS may affect the penile foreskin, glans, meatus, and urethra. Treatment is multifaceted, ranging from pharmacotherapy to surgery. Read More

Int J Cancer 2017 Mar;140(5):1134-1146

MRC-University of Glasgow Centre for Virus Research, University of Glasgow.

It is universally accepted that high-risk human papillomavirus (HR-HPV) is the cause of cervical dysplasia and cancer. More recently, it has been shown that HPV is also a marker of clinical outcome in oropharyngeal cancer. However, contemporary information is lacking on both the prevalence of HPV infection in vulvar cancer (VSCC), its precursor lesion, vulvar intraepithelial neoplasia (VIN) and the influence of HPV-status on the prognosis of this malignancy. Read More

Rom J Morphol Embryol 2016 ;57(2 Suppl):817-823

Department of Ophthalmology, "Grigore T. Popa" University of Medicine and Pharmacy, Iassy, Romania;

Lichen sclerosus et atrophicus and limited systemic scleroderma (acrosclerosis) are inflammatory skin diseases that ultimately evolve into two distinct modes of atrophic scar formation, but which can easily be confused clinically. They are very rarely associated. The literature has reported cases in which lichen sclerosus was associated with various forms of scleroderma, but often with localized morphea. Read More

Pathologe 2016 Nov;37(6):526-533

Institut für Pathologie, Abteilung Mamma-, Gynäko- und Perinatalpathologie, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103, Leipzig, Deutschland.

The majority of precancerous lesions of the lower female genital tract (intraepithelial neoplasia, IN) are caused by human papillomavirus (HPV) infections resulting in cellular atypia and in turn an altered tissue architecture. Depending on the pathogenesis, a distinction is made between vulvar intraepithelial neoplasia (VIN) classified as classical VIN associated with high-risk HPV infections (u-VIN) and differentiated VIN (d-VIN), which is associated with lichen sclerosus et atrophicus and p53 alterations. In the current World Health Organization (WHO) classification a novel grading system for squamous cell precancerous lesions of the lower female genital tract has been proposed, differentiating low grade squamous intraepithelial lesions (L-SIL) including condyloma and HPV-associated alterations plus VIN 1, vaginal intraepithelial neoplasia (VaIN 1) and cervical intraepithelial neoplasia (CIN 1) from high grade squamous intraepithelial lesions (H-SIL) with VIN 2 and 3, VaIN 2 and 3 as well as CIN 2 and 3. Read More

Clin Dermatol 2016 Sep-Oct;34(5):614-22. Epub 2016 May 20.

Department of Dermatology, University of Texas at Southwestern Medical Center, Dallas, TX. Electronic address:

Phototherapy is an effective treatment strategy for a variety of sclerosing skin conditions. There are a number of phototherapeutic modalities used for the treatment of sclerosing skin conditions, including ultraviolet (UV)A1, broadband UVA, psoralen plus UVA, and narrowband UVB phototherapy. As controlled trials with validated outcome measures are lacking for these therapies, existing evidence is largely level II for morphea and is even more minimal for scleroderma and other sclerosing disorders (scleroderma, lichen sclerosus, and chronic graft-versus-host disease, among others). Read More

Contact Dermatitis 2016 Oct;75(4):243-4

Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, 50125, Florence, Italy.

Clin Ter 2016 Jul-Aug;167(4):113-20

Department of Mental and Physical Health and Preventive Medicine Faculty of Medicine and Surgery, Second University of Naples.

Introduction: Female genitalis lichen sclerosus (FGLS) occurs on skin and mucous membranes and shows inflammatory lesions, chronic atrophic, itching and pain. These physical damages produce a decline in sex and a resulting relational couple discomfort.

Aim: We describe the discomfort and the relationship between physical and psychological damage. Read More

An Bras Dermatol 2016 Jul-Aug;91(4):534-6

Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil.

Lichen sclerosus is an uncommon inflammatory dermatosis with preferential involvement of the urogenital region. The extragenital involvement is uncommon and is characterized by small rounded macules or papules, pearly white in color. The coexistence of lichen sclerosus and scleroderma plaques in most cases with extragenital location has been reported in the literature. Read More

Case Rep Dermatol 2016 May-Aug;8(2):164-70. Epub 2016 Jun 6.

Florida Spine Institute, Clearwater, Fla., USA.

A patient reported to the Florida Spine Institute (Clearwater, Fla., USA) with severe lichen sclerosus of the anogenital region and legs. The patient's pain presentation was neuropathic with hypersensitivity, allodynia, swelling, and weakness. Read More

J Eur Acad Dermatol Venereol 2017 Feb 16;31(2):e97-e98. Epub 2016 Jul 16.

Dermatology, UCLH, London, UK.

Am J Dermatopathol 2017 Jan;39(1):59-61

*Departments of Pathology, and †Dermatology, Wake Forest School of Medicine, Winston Salem, NC.

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory scarring disease with a predilection for the anogenital area; however, 15%-20% of LSA cases are extragenital. The folliculocentric variant is rarely reported and less well understood. The authors report a rare case of extragenital, folliculocentric LSA in a 10-year-old girl. Read More

Gynecol Oncol 2016 Sep 7;142(3):420-6. Epub 2016 Jul 7.

Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom. Electronic address:

Objective: In this study, we investigated if the presence of histologically abnormal epithelium adjacent to the primary tumour influenced the frequency, timing, and topography of local vulvar recurrences (LVR) following treatment for squamous cell carcinoma of the vulva (VSCC).

Methods: The study population comprised a cohort of 201 consecutive cases with incident VSCC. LVR were categorised as local relapses (LR) if they occurred <2cm from the tumour margins, and as second field tumours (SFT) when ≥2cm from these margins. Read More

Am J Dermatopathol 2017 Mar;39(3):177-180

*Private Dermatohistological Laboratory, Nuernberg, Germany; †Institute of Pathology, Medical University Innsbruck, Innsbruck, Austria; ‡Private Pathological Laboratory, Salzburg, Austria; and §Clinical Department of Dermatology & Venereology, Medical University Innsbruck, Innsbruck, Austria.

Annular lichenoid dermatitis of youth (ALDY) is a more recently described inflammatory disease of the skin of unknown etiology with clinical similarities to morphea. The authors clinically, histopathologically, and immunohistochemically investigated 14 biopsies from 12 patients in western Austria with this disease. There were 6 female and 6 male patients with solitary (n = 7) and multiple lesions (n = 5) affecting the trunk (n = 11), upper arm (n = 2), thigh (n = 1), and calf (n = 1). Read More

Urologe A 2016 Jun;55(6):829-42

Gemeinschaftspraxis für Dermatologie und Urologie, Gießen, Deutschland.

The urological examination of male patients includes an inspection of the external genitalia whereby a variety of dermatological alterations can be found. Not all dermatological findings are of clinical relevance. Pearly penile papules and heterotopic sebaceous glands are examples of normal physiological variations. Read More

Int J Dermatol 2016 Oct 27;55(10):1076-81. Epub 2016 May 27.

Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Lichen sclerosus (LS) is an uncommon idiopathic chronic inflammatory debilitating disease with predilection for the genital region. Our recent encounter with an LS case exhibiting perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with LS at our institution.

Materials And Methods: All cases of LS diagnosed between 1990 and 2014 were retrospectively reviewed. Read More

J Eur Acad Dermatol Venereol 2017 Feb 27;31(2):e81-e83. Epub 2016 May 27.

Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.

JAMA Dermatol 2016 Aug;152(8):928-33

Section of Pathology, Oncology, and Experimental Biology, Department of Morphology, Surgery, and Experimental Medicine, University of Ferrara, Ferrara, Italy.

Importance: The molecular mechanism leading to the development of vulvar squamous cell carcinoma (VSCC) from vulvar lichen sclerosus (VLS) is unknown.

Objective: To assess the possible involvement of the IRF6 tumor-suppressor gene in the development of VSCC from VLS.

Design: In laboratories at the University of Ferrara, Ferrara, Italy, IRF6 gene expression and promoter methylation were investigated in paraffin-embedded VSCC and adjacent vulvar intraepithelial neoplasia (VIN) and VLS specimens, in cancer-free VLS (cfVLS) specimens, and in healthy skin specimens by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) analysis and by sequencing of PCR-amplified bisulfite-treated DNA. Read More

Investig Clin Urol 2016 May 10;57(3):202-7. Epub 2016 May 10.

Department of Urology, University of Michigan, Ann Arbor, MI, USA.

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. Read More

J Low Genit Tract Dis 2016 Jul;20(3):e40-1

1Maternity and Gynaecology, John Hunter Hospital, New Lambton, New South Wales; 2Obstetrician and Gynaecologist, East Melbourne, Victoria; and 3Anatomical Pathology, Pathology North, Hunter New England, New Lambton, New South Wales; and Faculty of Medicine and Health, University of Newcastle, Callaghan, New South Wales, Australia.

J Am Acad Dermatol 2016 May;74(5):e97-8

University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York. Electronic address:

Dtsch Med Wochenschr 2016 Apr 14;141(8):535, 583-4. Epub 2016 Apr 14.

Eur J Dermatol 2016 Jun;26(3):321-2

Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.

Georgian Med News 2016 Feb(251):58-64

1Department "Medicinal Information and Non-interventional studies", Bulgarian Drug Agency, Sofia, Bulgaria; 2"Onkoderma"- Ambulatory Clinic for Dermatology and Skin Surgery, Sofia, Bulgaria; 3Department of General and Clinical Pathology, Medical Faculty, "Saint Kliment Ohridski University"; 4Dermatology Department, University Hospital of Coimbra, Praceta Mota Pinto, Portugal; 5Department of General and Clinical pathology, Medical University of Plovdiv, Bulgaria; 6Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.

We describe a rare case of a 28 year-old male patient presenting with pruritus and increased sensitivity of the prepuce accompanied by erythematous confluent papules, unilateral nevus flammeus (NF) along almost the whole length of the right lower limb and two dysplastic nevi (DN), one located on the mid back and the other on the medial border of the right fifth toe, the latter coinciding with the NF. A biopsy of the prepuce revealed lichen sclerosus et atrophicus (LSA). Mental health assessment revealed anxiety disorder and predisposition to panic attacks. Read More

Am J Med Sci 2016 Mar 2;351(3):319-20. Epub 2016 Feb 2.

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

J Urol 2016 Sep 9;196(3):782-6. Epub 2016 Mar 9.

Institute of Urology, Lahey Hospital and Medical Center, Burlington, Massachusetts; Department of Colon and Rectal Surgery (PWM), Lahey Hospital and Medical Center, Burlington, Massachusetts. Electronic address:

Purpose: Alternative grafts are needed for patients who are not suitable candidates for oral mucosa graft harvest or who have a paucity of oral mucosa graft available for reconstruction. Circumferential colonic mucosal grafts have demonstrated feasibility for urethral reconstruction, although sigmoid resection has been required for graft retrieval. We report the feasibility and short-term outcomes of urethral reconstruction using a rectal mucosa graft harvested by a novel, minimally invasive, transanal endoscopic microsurgical technique. Read More

Am J Dermatopathol 2016 Aug;38(8):593-7

*Department of Dermatology, Ackerman Academy of Dermatopathology, New York, NY; †Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; ‡Department of Dermatology, Rutgers Robert Wood Johnson Medical School Piscataway, NJ; and §Department of Dermatology, The Medical University of South Carolina, Charleston, SC.

Alterations in dermal collagen are noted in dermatofibroma, dermatofibrosarcoma protuberans, morphea, lichen sclerosus et atrophicus, hypertrophic scars, and keloids. The authors sought to determine whether variations in birefringence of collagen by polarized microscopy could be of help in diagnosing such conditions. Representative hematoxylin and eosin sections of 400 cases, including dermatofibroma, dermatofibrosarcoma protuberans, hypertrophic scars, keloid, morphea, and lichen sclerosus, were examined under polarized microscopy. Read More

Ophthal Plast Reconstr Surg 2017 May/Jun;33(3S Suppl 1):S56-S58

*Departments of Ophthalmology and Visual Neurosciences, and †Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A.

Lichen sclerosus is a chronic, debilitating, and recurring disease that is most commonly seen affecting the anogenital region. Extragenital locations of lichen sclerosus has been well documented, frequently seen in the shoulders, neck, trunk, breasts, and arms, however, infrequently of the face. Specifically, extragenital lichen sclerosus has been reported in several cases to be involving the infraorbital region, but to our knowledge it has never been found affecting the adnexa of the eye. Read More

Am J Dermatopathol 2016 Aug;38(8):638-9

*Department of Pathology, Hospital Universitario 12 de Octubre, Instituto de Investigación I+12, Facultad de Medicina, Universidad Complutense, Madrid, Spain †Department of Dermatology, Hospital Universitario 12 de Octubre, Instituto de Investigación I+12, Madrid, Spain.

Urology 2016 05 15;91:215-21. Epub 2016 Feb 15.

Lahey Hospital and Medical Center, Burlington, MA. Electronic address:

Objective: To evaluate the intermediate-term outcomes from a large, single institution series of patients with lichen sclerosus (LS) who underwent surgical management of their urethral strictures.

Materials And Methods: We retrospectively reviewed 79 patients who underwent surgical management of their LS urethral strictures from 2003 to 2014, comparing outcomes of patients undergoing a single-stage buccal mucosa graft (BMG) urethroplasty, 2-stage BMG urethroplasty, or perineal urethrostomy (PU). Demographic and surgical outcomes data were collected for all patients. Read More

J Coll Physicians Surg Pak 2016 Feb;26(2):134-7

Clinic of Urology, Samsun Training and Research Hospital, Samsun, Turkey.

Objective: To evaluate histopathological results of foreskin removed during circumcision in the pediatric age group and the relationship between these and the degree of phimosis.

Study Design: Cross-sectional study.

Place And Duration Of Study: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey, from June to December 2014. Read More

Urol Int 2016 2;97(1):98-103. Epub 2016 Feb 2.

Department of Urology and Andrology, University of Perugia, Perugia, Italy.

Lichen sclerosus (LS) is an inflammatory and chronic disease that causes itching, pain, dysuria, urinary retention, dyspareunia and sexual dysfunction, in both men and women. The first line pharmacological treatment is based on the use of topical steroids, which have proved their efficacy in 60-70% of cases but with a high rate of relapses in time (50-80% of the patients of both sexes). The purpose of our non-randomised prospective pilot study was to evaluate the efficacy and tolerability of a new loco regional therapy with polydeoxyribonucleotides (PDRN) in the treatment of male genital LS. Read More

J Obstet Gynaecol 2016 May 22;36(4):518-21. Epub 2016 Jan 22.

d Department of Gynaecological Oncology , Sheffield Teaching Hospitals , Sheffield , UK.

Vulval cancers are rare, but after primary treatment, known to recur with a high frequency (30%). Clinico-pathological predictors of recurrence have been established to a great extent. However, there is paucity of literature on predictors of early versus late recurrence. Read More

Acta Obstet Gynecol Scand 2016 Apr 18;95(4):467-72. Epub 2016 Feb 18.

Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Introduction: The objective of this study was to analyse complications after surgical intervention on the vulva, especially with grafting of the vaginal epithelium, for the relief of dyspareunia in women with lichen sclerosus.

Material And Methods: A case series of 23 women with histologically confirmed lichen sclerosus who underwent vulvar surgery because of disabling sexual dysfunction. Surgical care was provided in a university hospital (tertiary referral center) between 2008 and 2012. Read More

Clin Dermatol 2016 Jan-Feb;34(1):3-7. Epub 2015 Nov 17.

Domestic and Specialized Medicine Centre "Dilmed", ul. Bohaterów Monte Cassino 3, 40-231 Katowice, Poland. Electronic address:

For many years, the biblical term tzaraat has referred to leprosy. In fact, the disease or diseases described under this name have no relationship to leprosy, as it was known in the Middle Ages or today; moreover, the term referred not only to skin disease, but also to the state of the ritual impurity and punishment for the sins. Although the real nature of tzaraat remains unknown, the differential diagnosis might include the following: Psoriasis, seborrheic dermatitis, favus, dermatophyte infections, nummular dermatitis, atopic dermatitis, pityriasis rosea, crusted scabies, syphilis, impetigo, sycosis barbae, alopecia areata, furuncles, scabies, neurodermatitis, scarlet fever, lupus erythematosus, lichen sclerosus et atrophicus, folliculitis decalvans, morphea, sarcoidosis, and lichen planopilaris. Read More

Int Urol Nephrol 2016 Apr 11;48(4):541-5. Epub 2016 Jan 11.

Sava Perovic Foundation (RD), Belgrade, Serbia.

Purpose: To report our ongoing experience with dorsal buccal mucosa graft (BMG) urethroplasty for the primary repair of anterior urethral strictures in patients with lichen sclerosus (LS).

Patients And Methods: A total of 32 men with LS underwent BMG urethroplasty from January 2010 to September 2012. In 27 patients, stricture was limited to the penile urethra, while in five patients, both bulbar and penile urethra were involved. Read More