Perineostomy: the last oportunity.
OBJECTIVE
To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure.


METHODS
We studied 17 patients who underwent perineal urethrostomy between 2009-2013 in a single hospital. Success was defined as no need for additional surgical treatment or urethral dilatation. We reviewed the clinical data related to age, weight, previous urethral surgery, diabetes, hypertension, ischemic cardiopathy, lichen sclerosus and other causes and studied their association with the procedure failure (univariate analysis). We completed the analysis with a multivariate test based on binary regression.


RESULTS
The average follow-up was 39.41 months. From all the causes, we found Lichen Sclerosus in 35 %, idiopathic etiology in 29 % and prior hypospadia repair in 18 %. Postoperative failure occurred in 3 patients, with a final success of 82.4 %. The binary regression model showed as independent risk factors ischemic cardiopathy (OR: 2.34), and the presence of Lichen Sclerosis (OR: 3.21).


CONCLUSIONS
The success rate with the perineal urethrostomy technique shows it to be a valid option above all when we preserve the urethral blood supply and plate. Lichen sclerosus and ischemic vascular problems are risk factors to re-stenosis.
Department of Urology, Reina Sofía Universitary Hospital, Córdoba, Spain.
Juan Carlos Regueiro
JC
Lopez
Department of Urology, Reina Sofía Universitary Hospital, Córdoba, Spain.
Enrique Gomez
EG
Gomez
Department of Urology, Reina Sofía Universitary Hospital, Córdoba, Spain.
Alberto Alonso
AA
Carrillo
Department of Urology, Reina Sofía Universitary Hospital, Córdoba, Spain.
Roque Cano
RC
Castineira
Department of Urology, Reina Sofía Universitary Hospital, Córdoba, Spain.
Maria Jose Requena
MJ
Tapia
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D052798:Balanitis Xerotica Obliterans / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000379:methods*; D010502:Perineum / Q000601:surgery*; D011859:Radiography; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D014521:Urethra / Q000000981:diagnostic imaging / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods