Evaluation of the efficacy of perineal urethrostomy for patients with anterior urethral stricture: insights from surgical and patient-reported outcomes

Shinchi, Masayuki; Horiguch, Akio; Ojima, Kenichiro; Kawamura, Kazuki; Hirano, Yusuke; Takahashi, Eiji; Kimura, Fumihiro; Azuma, Ryuichi; Ito, Keiichi

doi:10.1007/s00345-021-03795-2

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…The majority (84.6%) of the patients were satisfied or very satisfied with the surgery outcome. This study reported an improvement in subjective symptoms (questionnaires) and objective measures of urination [12] . The higher recurrence rate in our study versus the aforementioned study (22.6% vs 7.1%) is probably related to the longer median follow-up of our patients.…”

Section: Discussionmentioning

confidence: 58%

Proximal Urethrostomy Versus Urethroplasty for Complex Urethral Strictures

Rahav,

Udah,

Cohen

et al. 2024

European Urology Open Science

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Section: Discussionmentioning

confidence: 58%

Proximal Urethrostomy Versus Urethroplasty for Complex Urethral Strictures

Rahav,

Udah,

Cohen

et al. 2024

European Urology Open Science

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“…On the other hand, PU is a viable option with a high success rate for patients with highly complicated stricture, those who do not opt for urethroplasty, those for whom urethroplasty is not possible due to comorbidities, and those who do not have hesitancy with sitting urination 28 . In previous HSUS series, it has been reported that 4.7%–11.9% of patients underwent PU 8,11–13 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of urethral reconstruction for urethral stricture associated with hypospadias surgery in adults

et al. 2022

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Objectives We report our experience with urethral reconstruction for hypospadias surgery‐related urethral stricture in terms of surgical and patient‐reported outcomes. Methods Twenty‐nine adult males who underwent urethral reconstruction for hypospadias surgery‐related urethral stricture between August 2008 and January 2022 were retrospectively reviewed. Uroflowmetry and patient‐reported outcomes were evaluated at 3, 6, and 12 months, and annually thereafter. Surgical success was defined as the absence of additional procedures. Patients were asked to rate their satisfaction with urethral reconstruction as “very satisfied”, “satisfied”, “unsatisfied”, or “very unsatisfied”. Results The median patient age at referral was 43 years. The median number of previously performed hypospadias surgeries was three, and 18 patients (62.8%) had been treated with repeated transurethral procedures. The median stricture length was 54 mm (interquartile range 36–81). Performed urethral reconstruction included staged urethroplasty in 22 (75.9%), one‐stage onlay augmentation in 3 (10.2%), and perineal urethrostomy in 4 (13.8%) cases. Urethral reconstruction was successful in 26 patients (89.7%) over a median postoperative period of 31 months. Patient‐reported outcomes were assessed in 25 (86.2%) patients. The mean maximum flow rate, international prostate symptom score total score, international prostate symptom score quality of life score, and EuroQol‐5 dimensions index significantly improved postoperatively. Twenty‐three patients (92%) were “very satisfied” or “satisfied” with the outcome of their urethral reconstruction. Conclusions Urethral reconstruction is a highly successful and patient‐satisfying treatment for hypospadias surgery‐related urethral stricture in adult patients. Perineal urethrostomy is a reasonable alternative for elderly patients and for patients with complicated hypospadias surgery‐related urethral strictures.

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