Perineal urethrostomy for severe urethral stricture disease: a pilot study demonstrating enhanced quality of life | ||
| The Journal of Genital Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 01 February 2022 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/jgs.2018.3533.1013 | ||
| Authors | ||
| Peter Tsambarlis* 1; Raymond Yong1; Laurence A Levine2 | ||
| 1Rush University Medical Center, Urology, Chicago, IL, USA | ||
| 2Rush University Medical Center | ||
| Abstract | ||
| Introduction: Currently, urethral strictures are managed primarily via endoscopic procedures and urethroplasty. There is a cohort of men, however, who do not have a durable long-term response after these procedures. We have treated a group of men with refractory stricture disease with a perineal urethrostomy (PU). Aim: To evaluate the quality of life and satisfaction in men who underwent PU as the definitive management of their stricture disease. Methods: Eleven men underwent PU at our institution in lieu of secondary urethroplasty for severe recurrent urethral stricture disease since 2007. Seven were available for questioning and were surveyed on their quality of life via a previously published questionnaire. Results: The mean age of the patients in this series was 56.8 years at the time of surgery (range, 36–82 years). Mean follow-up was 58.4 months (SD=42 months). Owing to the severity of their disease, 6/7 (86%) men were unable to stand to void preoperatively. At the time of the interview, no patient had undergone a subsequent surgical procedure for his urethral stricture disease. Overall long-term satisfaction was 100%. Six (86%) reported either ‘good’ or ‘excellent’ results. One man reported psychological consequences (depression), which was present preoperatively and did not improve postoperatively. Two men reported issues with their sexual function, and one of those two men reported it to be severe. Two men reported that the PU caused an issue with their partner, associated with episodes of incontinence. Conclusion: PU appears to be a feasible and important option for men who have failed other forms of treatment and are not considered good candidates for definitive and often complex urethroplasty. High levels of satisfaction are possible with patient counseling and the establishment of reasonable expectations. | ||
| Keywords | ||
| Perineal urethrostomy; quality of life; severe stricture disease; urethral stricture | ||
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