The exact cause of these strictures may be related to the past use of perineal urethrostomy
for urinary drainage following hypospadias repair, repeated instrumentation, congenital or possibly ischemic bulbar urethral stricture.
So the urinary flow was diverted through a permanent perineal urethrostomy. Differently from the paper of Wylie and Payne, a permanent urinary meatus was created in the perineum after penile amputation, as distal as possible from the anus to avoid faecal contamination and urine scalding.
Even though stricture formation can be a complication in 1/3 of perineal urethrostomy cases during early postoperative period and after removal of the urinary catheter [23-26], we did not observe dysuria due to urethral stricture.
Several region-related discrepancies were also found for some core or potentially core procedures, including laparoscopic adrenalectomy, laparoscopic pyeloplasty, pediatric hernia repair, laparoscopic partial nephrectomy, ESWL, perineal urethrostomy
, radical urethrectomy, open adrenalectomy, female mid-urethral sling, varicocelectomy, and transrectal ultrasound (TRUS) biopsy (Table 5).
Management variables included dilatation, DVIU, laser urethrotomy, excision and primary anastomosis (EPA) urethroplasty, and perineal urethrostomy.
During 1972-82 period, a total of 117 (7.3%) stricture patients were admitted in the Urology Ward; 91 (77.7%) were treated by intermittent urethral dilatation, 12 (10.2%) were managed by initial railroad catheterisation followed by intermittent dilatation, and 14 (11.9%) patients were treated by perineal urethrostomy. During the period of 1983-93, a total of 151 (9.4%) stricture urethra patients were admitted; 96 (63.5%) were treated by intermittent dilatation, 25 (16.5%) with DVIU, 11 (7.2%) patients with
Treatment options vary from blind dilatations to perineal urethrostomy
, with a wide range of treatments in-between like visual internal urethrotomy, urethroplasty using genital skin flaps or grafts, extra genital skin grafts used as either as patches or tubes.
(14) The authors prefer to do this in a staged manner creating a perineal urethrostomy
first and then 6 months later, if the urethroplasty remains stable, performing the second stage to complete the reconstruction of the urethra.
We performed a complete necrosectomy and created a perineal urethrostomy