會陰部尿道造廔術：提供解決複雜性尿道狹窄的最後一個機會

廖凡霆、王大民、江仰仁、王敘涵、林國仁、林志德、潘柏諺、朱聖賢

林口長庚紀念醫院 外科部 泌尿科

Perineal Urethrostomy: Last Resort for Complex Urethra Stricture 

Fan-Ting Liao, Ta-Min Wang, Yang-Jen Chiang, Hsu-Han Wang,

 Kou-Jen Lin, Chih-Te Lin, Pai-Yen, Pan, Sheng-Hsien Chu

Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

Purpose:

        Management of male urethral stricture is an old but still challenging dilemma, especially in cases of complex or recurrence disease failing from previous urethroplasty or optic urethrotomy. There is limited experience and under-utilization of perineal urethrostomy (PU) in Taiwan. Therefore, we presented clinical outcomes of 5 cases who underwent perineal urethrostomy.

Materials and Methods:

        We studied 5 patients who underwent perineal urethrostomy between 2015 to June 2023. PU was performed by single experienced Urologist with Blandy technique. Surgical success was defined as no need of additional intervention for urethral stricture. We also studied clinical data of patient demographics, pre-operative parameters, prior stricture related interventions, comorbidities, and post-operative complications. Outcomes analysis included maximum urinary flow (Qmax), urinary symptoms, quality of life (QoL) and patient satisfaction.

Results:

        PU was successful in 100% of patients, with a mean follow-up of 23.8 months. Mean age was 63 ± 10.5 years (Range: 47-78). Prior to PU, 2 patients had failed optic urethrotomy, 3 had suprapubic cystostomy, 4 had urinary tract infection. Substantial improvements were noted for Qmax, lower urinary tract symptoms and LUTS-specific quality of life. 80% of patients were “satisfied” or “very satisfied” with the outcome.

Conclusion: