Introduction: The true incidence of urethral involvement in patients with genital lichen sclerosus (LS) is unknown. We review the epidemiology and discuss the pathogenesis of LS and urethral stricture diseases. Materials and Methods: During the period 1991-2002, of 925 patients who underwent urethroplasty for anterior urethral stricture, 130 patients (14 %) received the diagnosis of LS. In all patients with LS the histology was re-examined to confi rm the clinical diagnosis. Retrograde and voiding urethrography was used to establish urethral involvement in the disease. Results: In 106 patients (82 %) the histology provided the classical features of LS, and 24 patients (18 %) showed some histological variations. In 49 patients (37 %) the LS involved the pendolous urethra (meatus-navicularis-penile), and in 53 cases (41 %) a panurethral stricture was evident. Conclusions: LS urethral involvement appears to be a much more common and extensive disease than previously reported, and requires particular care in its early diagnosis.
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