PERINEAL URETHROSTOMY: JOURNEY REVISITED

Abstract

Introduction: Hesitation to offering a perineal urethrostomy to a patient is on the false belief that the satisfaction in regards to urination and sexual performance is low. Method: We have done observational descriptive study and evaluated 50 patients. We included patients between the ages of 40-70 years with urethral stricture diseases and excluded patients who were having PFUD disease and those who have not completed their family. Quality of life is calculated using validated questionnaire by PROM-USS. Results: Most of our patients were in 60-70 years' age group 30/50 i.e. 60%. Most common aetiology of stricture was idiopathic (18) followed by iatrogenic (15), traumatic (9) and post infectious (8). Average length of stricture was more than 6 cm and involving anterior urethra. Patients were followed up for median 14 months. Preoperative IPSS score was 27+/- 4.5 and postoperative was 9+/- 5. SHIM scoring preoperative and postoperative were same ~ 21. PROM-USS for LUTS was signicantly reduced from median of 19 to 8.5 and QOL from median of 5.5 to 2. Success rate with previous urethrotomy, urethroplasty, multiple treatment and no treatment patients were 15/17(88%), 9/12(75%), 11/14(78%), 7/7(100%) respectively. Most of the patients were satised with the procedure. And few of them (3) reported that postejaculatory dysfunction bothering them. In patients in whom second surgery was indicated that is in patients with bladder outlet obstruction the endoscopic procedure was done without any difculty. Conclusions: These reports will likely increase the acceptance of perineal urethrostomy by patients and as well as urologists.