Clinical Outcome and Quality of Life Assessment in Patients Treated With Perineal Urethrostomy for Anterior Urethral Stricture Disease

Guido Barbagli, Michele De Angelis, Giuseppe Romano, Massimo Lazzeri

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Purpose: We performed a quality of life assessment for patients treated with perineal urethrostomy for anterior urethral stricture disease. Materials and Methods: We retrospectively reviewed 173 patients (median age 55 years) who underwent perineal urethrostomy (from 1978 to 2007) as part of a plan for a staged urethroplasty repair for a complex anterior urethral stricture. The perineostomy was made using flap urethroplasty. The clinical outcome was considered a failure when postoperative instrumentation was needed. A questionnaire was used to evaluate patient quality of life and satisfaction. Results: Stricture etiology was unknown in 50.3% of the cases, lichen sclerosus in 17.3%, catheter in 13.3%, instrumentation in 8.7%, failed hypospadias repair in 4.6%, trauma in 4.1% and infection in 1.7%. Stricture length was 1 to less than 2 cm in 1.2% of cases, 2 to less than 3 cm in 3.5%, 3 to less than 4 cm in 12.1%, 4 to less than 5 cm in 13.8%, 5 to less than 6 cm in 7.5%, greater than 6 cm in 4.1% and panurethral in 57.8%. Of 173 patients 91 (52.6%) underwent prior urethroplasty. Median followup length was 62 months (range 12 to 361). Of 173 cases 121 (70%) were successful and 52 (30%) were failures, requiring revision of the perineostomy. Of 173 patients 135 (78%) were satisfied with the results obtained with surgery, 33 (19.1%) were very satisfied, 127 (73.4%) with a median age of 57 years (range 23 to 85) refused to do the second stage of urethroplasty and 46 (26.6%) with a median age of 47.5 years (range 27 to 72) are currently on a waiting list for the second stage of urethroplasty. Conclusions: Perineostomy is a necessary procedure for patients with complex urethral pathology and satisfaction rates are high.

Original languageEnglish
Pages (from-to)548-557
Number of pages10
JournalJournal of Urology
Volume182
Issue number2
DOIs
Publication statusPublished - Aug 2009

Fingerprint

Urethral Diseases
Urethral Stricture
Quality of Life
Pathologic Constriction
Lichen Sclerosus et Atrophicus
Hypospadias
Waiting Lists
Catheters
Pathology
Wounds and Injuries
Infection

Keywords

  • surgical stomas
  • urethra
  • urethral stricture
  • urinary diversion

ASJC Scopus subject areas

  • Urology

Cite this

Clinical Outcome and Quality of Life Assessment in Patients Treated With Perineal Urethrostomy for Anterior Urethral Stricture Disease. / Barbagli, Guido; De Angelis, Michele; Romano, Giuseppe; Lazzeri, Massimo.

In: Journal of Urology, Vol. 182, No. 2, 08.2009, p. 548-557.

Research output: Contribution to journalArticle

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abstract = "Purpose: We performed a quality of life assessment for patients treated with perineal urethrostomy for anterior urethral stricture disease. Materials and Methods: We retrospectively reviewed 173 patients (median age 55 years) who underwent perineal urethrostomy (from 1978 to 2007) as part of a plan for a staged urethroplasty repair for a complex anterior urethral stricture. The perineostomy was made using flap urethroplasty. The clinical outcome was considered a failure when postoperative instrumentation was needed. A questionnaire was used to evaluate patient quality of life and satisfaction. Results: Stricture etiology was unknown in 50.3{\%} of the cases, lichen sclerosus in 17.3{\%}, catheter in 13.3{\%}, instrumentation in 8.7{\%}, failed hypospadias repair in 4.6{\%}, trauma in 4.1{\%} and infection in 1.7{\%}. Stricture length was 1 to less than 2 cm in 1.2{\%} of cases, 2 to less than 3 cm in 3.5{\%}, 3 to less than 4 cm in 12.1{\%}, 4 to less than 5 cm in 13.8{\%}, 5 to less than 6 cm in 7.5{\%}, greater than 6 cm in 4.1{\%} and panurethral in 57.8{\%}. Of 173 patients 91 (52.6{\%}) underwent prior urethroplasty. Median followup length was 62 months (range 12 to 361). Of 173 cases 121 (70{\%}) were successful and 52 (30{\%}) were failures, requiring revision of the perineostomy. Of 173 patients 135 (78{\%}) were satisfied with the results obtained with surgery, 33 (19.1{\%}) were very satisfied, 127 (73.4{\%}) with a median age of 57 years (range 23 to 85) refused to do the second stage of urethroplasty and 46 (26.6{\%}) with a median age of 47.5 years (range 27 to 72) are currently on a waiting list for the second stage of urethroplasty. Conclusions: Perineostomy is a necessary procedure for patients with complex urethral pathology and satisfaction rates are high.",
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