However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages. And also, there was no statistically significant change in patients' preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. The prospective study was conducted between January 2015 and August 2017 with 60 cases. To examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters.
As for patient satisfaction, 84.6% of patients (33/39) were “satisfied” (46.1%) or “very satisfied” (38.5%) with the outcome.ConclusionsPU had a high surgical success rate, and significantly improved patients’ subjective symptoms and achieved a high level of satisfaction. The SHIM score did not change significantly (from 2.6 at baseline to 2.3 postoperatively p = 0.59). The mean maximum flow rate, PVR, lower urinary tract symptoms (LUTS)-total score, LUTS-specific quality of life, and EuroQol-visual analog scale scores improved significantly from 3.8 mL/s, 77.6 mL, 12.9, 2.6, and 53.6 at baseline to 17.6 mL/s, 21.3 mL, 4.1, 0.9, and 74.9 postoperatively (p = 0.003, p = 0.004, p = 0.005, p < 0.0001, p < 0.0001, respectively). Thirty-nine patients (69.6%) filled out the questionnaires 6 months after surgery.
METIN2 BALANTIA SKIN
Two of four were salvaged by re-do PU, and one was salvaged by forming a composite stoma using a penile skin graft. The overall patient satisfaction was also assessed.ResultsPU was successful in 92.9% of patients (n = 52), with a median follow-up of 34 months. Uroflowmetry and measurement of residual urine volume (PVR) were examined postoperatively, and the patients were asked to fill out sexual health inventory for men (SHIM) and the validated Urethral Stricture Surgery Patient-reported Outcome Measure questionnaires before and after PU. Surgical success was defined as no need for additional intervention. Patients who underwent PU for anterior urethral stricture between 20 were retrospectively reviewed (n = 56). PurposeTo examine the efficacy of perineal urethrostomy (PU) in patients with anterior urethral stricture. A majority of patients also maintain a satisfactory erectile function. Permanent PU is an acceptable option for complex long-segment anterior urethral strictures, especially in elderly patients, with an excellent long-term outcome. The mean IIEF-5 score improved from 20.07 to 21.31 after PU, but this did not achieve statistical significance (p=0.3558). The number of patients with no erectile dysfunction increased from 55.4% to 67.8% after PU. A total of 129 (88.3%) patients had a successful surgery. The most common early and late postoperative complications were bleeding and stenosis of the urethrostomy, respectively. The median follow-up period was 26 months. All the patients had a history of previous surgery, and the average number of procedures per patient was 2.4. The median age at the time of surgery was 58☗.3 years. Fisher's exact test and χ2 test were used for statistical analysis. They were also evaluated with the International Index of Erectile Function (IIEF-5) questionnaire. Failure was defined as the need for any additional procedures. Patients were followed up at 3 months and then yearly. Patients with posterior urethral involvement were excluded. All patients had complex urethral strictures. We retrospectively evaluated 146 patients who underwent permanent PU at our institution from January 2000 to December 2018. This study aimed at evaluating the long-term voiding and erectile function of PU as a permanent procedure for such strictures. In complex strictures, especially in elderly patients, perineal urethrostomy (PU) provide excellent voiding function.
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