World journal of urology · 2025
Is perineal urethrostomy a last resort or a viable alternative? Comparative analysis with buccal mucosal graft urethroplasty.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Colakoglu Yunus, Ayten Ali, Gelmis Mucahit, Zilan Abdullah, Savun Metin, Simsek Abdulmuttalip
Аннотация
PURPOSE: We have aimed to compare perineal urethrostomy (PU) with buccal mucosal graft urethroplasty (BMGU) performed for the management of complex anterior urethral strictures (CAUS) regarding long-term sexual and functional outcomes of the patients.
MATERIALS AND METHODS: A total of 109 patients who underwent PU (n = 45) or BMGU (n = 64) between January 2018 and January 2024 were retrospectively reviewed. Patients with posterior urethral strictures, those who underwent staged or different type of urethroplasty, cases that were lost to follow-up, cases followed up for less than 1 year or refused to participate were not included in the study. Turkish validated Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM), International Index of Erectile Function (IIEF-5) and quality of life (EQ-5D and EQ-VAS) questionnaires were applied to the patients to evaluate their functional and erectile functions.
RESULTS: Patients who underwent PU were significantly older than those who underwent BMGU [median 64 (45-76) vs. 57 (44-69), respectively, p < 0.001]. Follow-up times of the two groups were similar [PU: median 39 (14-72) vs. BMGU: 42.5 (13-71), p = 0.537]. In the PU and BMGU groups, 86.7% and 89.1% of patients were very satisfied or satisfied with the operation, respectively. The median EQ-VAS score in the PU group was 85 (55-95) points. Maximum urinary flow rate (Qmax) values and postvoid residual urine volume (PVR) measurements were also comparable between the groups.
CONCLUSIONS: Permanent PU can be recommended for comorbid patients as a first-line treatment with resultant high success and patient satisfaction rates.
MATERIALS AND METHODS: A total of 109 patients who underwent PU (n = 45) or BMGU (n = 64) between January 2018 and January 2024 were retrospectively reviewed. Patients with posterior urethral strictures, those who underwent staged or different type of urethroplasty, cases that were lost to follow-up, cases followed up for less than 1 year or refused to participate were not included in the study. Turkish validated Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM), International Index of Erectile Function (IIEF-5) and quality of life (EQ-5D and EQ-VAS) questionnaires were applied to the patients to evaluate their functional and erectile functions.
RESULTS: Patients who underwent PU were significantly older than those who underwent BMGU [median 64 (45-76) vs. 57 (44-69), respectively, p < 0.001]. Follow-up times of the two groups were similar [PU: median 39 (14-72) vs. BMGU: 42.5 (13-71), p = 0.537]. In the PU and BMGU groups, 86.7% and 89.1% of patients were very satisfied or satisfied with the operation, respectively. The median EQ-VAS score in the PU group was 85 (55-95) points. Maximum urinary flow rate (Qmax) values and postvoid residual urine volume (PVR) measurements were also comparable between the groups.
CONCLUSIONS: Permanent PU can be recommended for comorbid patients as a first-line treatment with resultant high success and patient satisfaction rates.