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Perineostomy: the last oportunity
Juan Carlos Regueiro Lopez1, Enrique Gomez Gomez1, Alberto Alonso Carrillo1
1Department of Urology, Reina Sofía Universitary Hospital, Córdoba, Spain.
Summary
Perineal urethrostomy is a successful surgical option for urethral stricture, with an 82.4% success rate. Key risk factors for failure include ischemic heart disease and Lichen Sclerosus.
Area of Science:
- Urology
- Surgical Techniques
Background:
- Urethral stricture disease affects numerous patients, necessitating effective surgical interventions.
- Perineal urethrostomy is a reconstructive option for managing complex urethral strictures.
Purpose of the Study:
- To evaluate the efficacy and outcomes of perineal urethrostomy.
- To identify predictors of surgical failure in patients undergoing this procedure.
Main Methods:
- A retrospective review of 17 patients who underwent perineal urethrostomy between 2009 and 2013.
- Analysis of clinical data including patient demographics, comorbidities, and previous urethral surgeries.
- Univariate and multivariate logistic regression analyses were used to identify risk factors for failure.
Main Results:
- The overall success rate for perineal urethrostomy was 82.4% after an average follow-up of 39.41 months.
- Lichen Sclerosus (35%) and idiopathic etiology (29%) were the most common causes of stricture.
- Independent risk factors for procedure failure included ischemic cardiopathy (OR: 2.34) and Lichen Sclerosus (OR: 3.21).
Conclusions:
- Perineal urethrostomy is a viable surgical technique for urethral stricture, particularly when urethral blood supply and plate are preserved.
- Lichen Sclerosus and ischemic vascular disease are significant risk factors associated with re-stenosis after perineal urethrostomy.