Perineal Urethrostomy After Urethral Stricture: Step-by-Step Surgical Technique.
Renata Palopoli Silva, Lucas Azevedo Melo Uneda, Rodrigo Ribeiro Vieralves et al.
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Case in brief
A 73-year-old man with complex, recurrent urethral stricture after multiple reconstructive and endoscopic procedures underwent perineal urethrostomy. His history also included Bowen’s disease of the glans penis. The operation used an inverted U-shaped perineal incision, with the perineal skin sutured to the opened bulbar urethra; the dorsal urethral plate was preserved. There were no intraoperative complications. After catheter removal at 14 days, satisfactory voiding was documented. At 60-day follow-up, he reported a satisfactory urinary stream and improved quality of life.
What made this case unusual
The report’s focus is a step-by-step surgical technique that preserves the dorsal urethral plate and longitudinal blood flow in the corpus spongiosum during perineal urethrostomy.
Diagnostic / clinical pearl
For complex recurrent stricture, perineal urethrostomy is a reconstructive option; this technique preserves the dorsal urethral plate while creating the perineal meatus.