Perineal Urethrostomy

  • Andrew C. PetersonEmail author
Part of the Current Clinical Urology book series (CCU)


The perineal urethrostomy (PU) has often been indicated in patients as a temporizing procedure to bypass distal urethral obstruction and as the first step in different types of complex, staged urethroplasty procedures. In addition to these two indications, the PU was also used as a last resort surgical procedure in patients who had refractory distal obstruction. However, recently the PU has gained popularity as a definitive primary solution in multiple situations with complex obstructive urethral pathology offering a good solution to a bad situation with a straightforward surgical procedure resulting in good long-term outcomes and high patient satisfaction.


Foley Catheter Absorbable Suture Urethral Stricture Lichen Sclerosus High Patient Satisfaction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Barbagli G, Palminteri E, Lazzeri M, Guazzoni G, Turini D. Long-term outcome of urethroplasty after failed urethrotomy versus primary repair. J Urol. 2001;165(6 Pt 1):1918–9.PubMedGoogle Scholar
  2. 2.
    Whitson JM, McAninch JW, Elliott SP, Alsikafi NF. Long-term efficacy of distal penile circular fasciocutaneous flaps for single stage reconstruction of complex anterior urethral stricture disease. J Urol. 2008;179(6):2259–64.PubMedCrossRefGoogle Scholar
  3. 3.
    Eltahawy EA, Virasoro R, Schlossberg SM, McCammon KA, Jordan GH. Long-term followup for excision and primary anastomosis for anterior urethral strictures. J Urol. 2007;177(5):1803–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Santucci RA, McAninch JW, Mario LA, Rajpurkar A, Chopra AK, Miller KS, et al. Urethroplasty in patients older than 65 years: indications, results, outcomes and suggested treatment modifications. J Urol. 2004;172(1):201–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Peterson AC, Palminteri E, Lazzeri M, Guanzoni G, Barbagli G, Webster GD. Heroic measures may not always be justified in extensive urethral stricture due to lichen sclerosus (balanitis xerotica obliterans). Urology. 2004;64(3):565–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Barbagli G, De AM, Romano G, Lazzeri M. Clinical outcome and quality of life assessment in patients treated with perineal urethrostomy for anterior urethral stricture disease. J Urol. 2009;182(2):548–57.PubMedCrossRefGoogle Scholar
  7. 7.
    Elliott SP, Eisenberg ML, McAninch JW. First-stage urethroplasty: utility in the modern era. Urology. 2008;71(5):889–92.PubMedCrossRefGoogle Scholar
  8. 8.
    Sokoloff MH, Michel K, Smith RB. Complications of transurethral resection of the prostate. In: Taneja SS, Smith RB, Ehrlich RM, editors. Complications of urologic surgery: prevention and management. 3rd ed. Philadelphia: W.B. Saunders Company; 2001. p. 229–43.Google Scholar
  9. 9.
    Clark PB. Non-continent urinary diversion: perineal urethrostomy. In: Hinmnan F, editor. Atlas of urologic surgery. 2nd ed. Philadelphia: W. B. Saunders Company; 1998. p. 623–76.Google Scholar
  10. 10.
    French D, Hudak SJ, Morey AF. The “7-flap” perineal urethrostomy. Urology. 2011;77(6):1487–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Johanson B. Reconstruction of the male urethra and strictures. Acta Chir Scand. 1953;176:3–88.Google Scholar
  12. 12.
    Blandy JP, Singh M, Tresidder GC. Urethroplasty by scrotal flap for long urethral strictures. Br J Urol. 1968;40(3):261–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Flynn BJ, Delvecchio FC, Webster GD. Perineal repair of pelvic fracture urethral distraction defects: experience in 120 patients during the last 10 years. J Urol. 2003;170(5):1877–80.PubMedCrossRefGoogle Scholar
  14. 14.
    Pugliese JM, Morey AF, Peterson AC. Lichen sclerosus: review of the literature and current recommendations for management. J Urol. 2007;178(6):2268–76.PubMedCrossRefGoogle Scholar
  15. 15.
    Dubey D, Sehgal A, Srivastava A, Mandhani A, Kapoor R, Kumar A. Buccal mucosal urethroplasty for balanitis xerotica obliterans related urethral strictures: the outcome of 1 and 2-stage techniques. J Urol. 2005;173(2):463–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Peterson AC, Webster GD. Management of urethral stricture disease: developing options for surgical intervention. BJU Int. 2004;94(7):971–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Duckett JW, Coplen D, Ewalt D, Baskin LS. Buccal mucosal urethral replacement. J Urol. 1995;153(5):1660–3.PubMedCrossRefGoogle Scholar
  18. 18.
    Barbagli G, Lazzeri M. History and evolution of dorsal onlay urethroplasty for bulbar urethral stricture repair using skin or buccal mucosal grafts. Urologia. 2007;74(4):233–41.PubMedGoogle Scholar
  19. 19.
    Wessells H, McAninch JW. Use of free grafts in urethral stricture reconstruction. J Urol. 1996;155(6):1912–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Kamat N. Perineal urethrostomy stenosis repair with buccal mucosa: description of technique and report of four cases. Urology. 2008;72(5):1153–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Myers JB, Porten SP, McAninch JW. The outcomes of perineal urethrostomy with preservation of the dorsal urethral plate and urethral blood supply. Urology. 2011;77(5):1223–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Division of Urologic Surgery, Department of SurgeryDuke University Medical CenterDurhamUSA

Personalised recommendations