The "7-flap" perineal urethrostomy.
OBJECTIVE
Perineal urethrostomy is a well-accepted reconstructive option for complex anterior urethral stricture disease. We present a novel technique for the construction of a perineal urethrostomy that allows the surgeon greater control when managing all levels of anterior urethral stricture disease.


METHODS
A perineal urethrostomy is constructed by advancing a 7-shaped laterally based perineal skin flap to the amputated bulbar or membranous urethra.


RESULTS
Ten men between the ages of 48 and 79 underwent the 7-flap perineal urethrostomy for advanced urethral stricture disease; one had 7-flap revision of an existing perineal urethrostomy. Each patient was treated in an outpatient setting without perioperative complications. Nine of ten patients (90%) are voiding spontaneously without the need for urethrostomy revision or proximal urinary diversion.


CONCLUSIONS
The 7-flap perineal urethrostomy is versatile, safe, and effective. It allows the surgeon maximal flexibility in the management of complex anterior urethral stricture disease.
Department of Urology, UT Southwestern Medical Center, Dallas, Texas 75390, USA.
David
D
French
Steven J
SJ
Hudak
Allen F
AF
Morey
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*