Böyke Classification
I cannot provide information on the "Böyke classification" as this classification system does not appear in the current evidence base or established urological literature for urethral stricture disease.
Established Classification Systems for Urethral Strictures
The most clinically relevant and validated classification systems for urethral strictures are the LSE (Length, Segment, Etiology) classification and the U-score, not a "Böyke" classification. 1, 2
LSE Classification System (Most Recent and Validated)
The LSE classification system was developed and validated by the Trauma and Urologic Reconstructive Network of Surgeons (TURNS) and represents the current standard for staging anterior urethral stricture disease 1, 2:
Three Core Elements:
- Length (L): Categorizes strictures as short or long, with <2 cm being the critical threshold for treatment decisions 3, 4
- Segment/Location (S): Identifies whether the stricture involves bulbar, penile, fossa navicularis, or pan-urethral (3-segment) locations 1, 2
- Etiology (E): Classifies the cause as idiopathic, iatrogenic, traumatic, infectious, or lichen sclerosus 1, 2
Five Disease Stages:
- Stage I: Short bulbar strictures 1
- Stage II: Long bulbar strictures 1
- Stage III: Penile/fossa strictures of favorable etiology 1
- Stage IV: Penile/fossa strictures of adverse pathology (e.g., lichen sclerosus) 1
- Stage V: Pan-urethral (3-segment) disease 1
Clinical Utility
- The LSE staging system demonstrates an interrater reliability of 0.79, indicating excellent reproducibility 2
- The segment component strongly predicts urethroplasty type (p = 0.0005) and correlates with stricture etiology 2
- This system successfully predicts surgical complexity, functional outcomes, meatal location after repair, and number of surgeries required 1
Alternative: U-Score System
The U-score (urethral stricture score) assigns points based on four characteristics 5:
- Length: 1-3 points 5
- Number of strictures: 1-2 points 5
- Location: 1-2 points 5
- Etiology: 1-2 points 5
- Total score ranges from 4-9 points, with higher scores predicting greater surgical complexity and worse outcomes 5
ULTRA Measurement System
The ULTRA system evaluates five ultrasound-based parameters 6:
- U: Urethral stricture site 6
- L: Length 6
- T: Urethral stricture scar thickness 6
- R: Stricture diameter ratio (stricture to 10mm proximal urethral dilatation) 6
- A: Alone (single) or multiple urethral strictures 6
Common Pitfall: If you encountered "Böyke classification" in clinical discussion, clarify whether the speaker meant one of these established systems, as miscommunication about classification can lead to inappropriate treatment selection.