Algorithmic Midline Approach to Perineal Urethrostomy is Associated With Long-term Success and High Patient Satisfaction.
Urology
; 190: 133-139, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38490276
ABSTRACT
OBJECTIVE:
To assess surgical success and patient-reported outcomes of perineal urethrostomy via midline approach. MATERIALS ANDMETHODS:
Charts of patients undergoing primary perineal urethrostomy between May 2008 and June 2022 were reviewed. Background characteristics were assessed; success was defined as freedom from re-intervention. Patient-reported outcome measures were assessed using a cross-sectional phone survey. Several validated questionnaires were used to assess lower urinary tract symptoms, quality of life, and erectile dysfunction.RESULTS:
Among 1768 urethroplasties performed over the study period, 103 patients (5.8%) underwent midline perineal urethrostomy. Surgery was successful in 95.1% of cases (98/103); 5 patients (4.9%) required re-intervention at a median of 8.7 months. Post-operative complications occurred in 5.8% of cases (6/103) and were both mild and self-limited. Forty-nine patients (47.6%) were reached via phone survey at a median of 61 months post-operatively. Some questions were not answered by all patients. Most patients (42/49, 86%) were satisfied or very satisfied with surgical results, and 82% (40/49) reported an improvement in their overall health. Most patients (31/41, 76%) were unbothered by sitting to urinate. Although 20% of patients (10/49) reported post-operative urinary symptoms that interfered "a lot" with their daily life, only 3 (6%) of these patients reported dissatisfaction with the outcome. Regarding sexual function, 64% (27/42) reported indifference to or increased satisfaction with sexual encounters vs before surgery. The rate of de novo erectile dysfunction was 24% (12/49).CONCLUSION:
The midline approach to perineal urethrostomy provides excellent, durable success rates with high levels of patient satisfaction.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Perineum
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Urologic Surgical Procedures, Male
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Urethra
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Patient Satisfaction
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Patient Reported Outcome Measures
Limits:
Adult
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Aged
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Humans
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Male
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Middle aged
Language:
En
Journal:
Urology
Year:
2024
Type:
Article