Abstract
Referred by urology, a 69-year-old circumcised man with a 40-year history of biopsy-proven LS presented for evaluation of gradually worsening penile lesions, complicated by three recent hospitalizations for urosepsis. In recent years, urination had become exceedingly difficult in the context of urethral strictures, and the patient practises clean intermittent catheterization (CIC) with a 12-French catheter.
Urodynamic flow studies performed 2 months prior to presentation indicated detrusor overactivity with decreased capacity at 260 mL (normal range 350-500 mL). Previous treatments included a meatotomy, two urethrotomies and a remote history of topical clobetasol use.
On physical examination, the glans and coronal sulcus demonstrated significant erythema and atrophic scarring involving the meatus (Fig. 1a). Many years earlier, the patient had a biopsy, the findings of which were consistent with the diagnosis of LS.