REDO URETHROSTOMY

Introduction
Patient 50 years old who came to us after several surgical urethroplasties for bulbar urethral stricture. The patient had a perineostomy, but he referred obstructive symptoms and repeated urinary infections.

Material and methods
The video shows the surgical technique for revised perineostomy. Surgical technique: U inverted perineal incision. Removal of the scarred tissues and finding of the bulbar urethra. Complete transverse urethral incision: we can see the original urethral lumen and the false line on which the perineostomy had been created. The distal urethral stump is spatulated : then we perform the anastomosis of the two urethral stumps on the roof. We create again the perineal urethrostomy, this time joint correctly to the original urethra.

Results
From the histological examination it became evident that the diseased urethra had Lichen Sclerorus. Three months after the operation the patient was satisfied with the urinary flow.

Conclusions

Perineal urethrostomy is a foundamental technique of the urethral surgery. Sometimes the perineal urethrostomy might be affected by restrictures and therefore we must redo it.
Disclamer
Caution! Surgical images