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Vessel-sparing Excision and Primary Anastomosis

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The "7-flap" perineal urethrostomy.

David French¹, Steven J Hudak, Allen F Morey

¹Department of Urology, UT Southwestern Medical Center, Dallas, Texas 75390, USA.

|January 25, 2011

Summary

The novel 7-flap perineal urethrostomy offers a safe and effective solution for complex anterior urethral stricture disease. This technique provides surgeons with greater control and achieves high success rates in spontaneous voiding post-procedure.

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Area of Science:

Urology
Surgical Reconstruction

Background:

Anterior urethral stricture disease presents complex reconstructive challenges.
Perineal urethrostomy is an established surgical approach for these conditions.

Purpose of the Study:

To introduce and evaluate a novel 7-flap technique for perineal urethrostomy.
To assess the efficacy and safety of this technique in managing complex anterior urethral strictures.

Main Methods:

A 7-shaped, laterally based perineal skin flap was advanced to the amputated bulbar or membranous urethra.
The procedure was performed in an outpatient setting for ten male patients aged 48-79.

Main Results:

90% of patients (9 out of 10) achieved spontaneous voiding without needing revision or diversion.
The procedure was performed without perioperative complications.
One patient underwent revision of a prior perineal urethrostomy using the 7-flap technique.

Conclusions:

The 7-flap perineal urethrostomy is a versatile, safe, and effective surgical option.
This technique provides surgeons with enhanced flexibility for managing diverse anterior urethral stricture cases.

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