definitive perineal urethrostomy in patients with … · definitive perineal urethrostomy in...

DEFINITIVE PERINEAL URETHROSTOMY IN PATIENTS WITH FAILED HYPOSPADIAS REPAIR

DEFINITIVE PERINEAL URETHROSTOMY IN PATIENTS WITH FAILED HYPOSPADIAS REPAIRWITH FAILED HYPOSPADIAS REPAIRWITH FAILED HYPOSPADIAS REPAIR

Dr Giuseppe Romano

Center for Reconstructive Urethral Surgery - U O di Urologia Ospedale S Donato USL8 - ArezzoCenter for Reconstructive Urethral Surgery U.O. di Urologia Ospedale S.Donato USL8 Arezzo

Italy

Center for Reconstructive Urethral Surgery

Introductions


Introductions

observational, descriptive surveyobservational, descriptive survey1998 1998 -- 2007 2007

1176 failed primary 1176 failed primary hypospadiashypospadias repairrepair

urethral strictures urethral strictures penile penile defectsdefects


Introductions


Methods

The population of patients included those who informed us, “Iunderwent an innumerable number of prior failed operations. I amtired.” These words were usually from patients (mean age 53 years)who had undergone failed hypospadias repair (mean previouswho had undergone failed hypospadias repair (mean previousoperations 4.5), or repeat failed urethroplasty (mean previous operations4.1) or other conditions requiring periodic dilation or urethrotomy toavoid urinary retention. These patients were unable to accept thepossibility of another complete failed urethroplasty.


Methodspatient age married sons n°operations hypospadia concomitant pathology CF 49 no no 10 scrotal diabetes‐DownCB 65 si no 5 balanic BPICB 65 si no 5 balanic BPIDCG 33 no no 3 scrotal CRF‐ dialysisFG 67 si no 6 scrotalFM 64 si si 3 scrotalFM 64 si si 3 scrotalGS 41 si si 7 scrotalGP 58 si si 3 scrotalLBS 35 no no 2 scrotalLBS 35 no no 2 scrotalMG 64 si no 3 scrotalPG 58 si si 5 scrotal squamous CA PG 70 si si 13 penile diabetesPG 70 si si 13 penile diabetesPM 47 si no 10 scrotalPP 64 si no 12 scrotalSF 20 no no 2 scrotal heavy psychomotor delaySF 20 no no 2 scrotal heavy psychomotor delaySL 31 si no 8 scrotalCS 53 si no 13 scrotal anus‐scrotal malformation


16 DEFINITIVE PERINEAL URETHROSTOMY

Methods

6%

25%

Yes

No

19%37%

20-30

31-40

41-50

75%

Married

19%

19%

51-60

61-70

Age Married

6%6%

Age

31%

Yes

Balanic

Penile

S t l69%

No

Sons

88%Scrotal

Hypospadia


Hypospadia

Methods

Questionnaire

14 ti t14 patients


Surgical techniqueBlandy’s technique


Surgical technique


ResultsYes NoYes No

Has the perineal urethrostomy caused you any problems? 3 (21%) 11 (79%)Psychological problems 2 Urination problems Sexual activity problems 1

Yes NoHave you had problems with your partner due to this operation? 0 14 (100%)Psychological problems Penetration problems Minor problems

Are you pleased with the results obtained with surgery? Yes NoDissatisfiedA little satisfied Satisfied 6 (43%)Very satisfied 8 (57%)

Yes NoHow would you evaluate these results?Negative Fair/passable Good 7 (50%)Excellent 7 (50%)Excellent 7 (50%)

Yes NoWould you undergo this type of operation again? 14 (100%)

Yes No


Yes NoWould you like to undergo second stage urethroplasty 1 (7%) 13 (93%) to restore normal urinary function?

Results

16 814

121416

7 7

5678

68

10

1234

246 0 0

01

0

Yes No02

Would you do this type operation again? Patient satisfaction


Conclusions

- Definitive perineal urethrostomy is often a necessary procedure when dealing with complex urethral pathology

- Patient satisfaction following this surgical procedurei hi h d li f lif i i l i fl dis high and quality of life is not negatively influenced


Thank You

definitive perineal urethrostomy in patients with … · definitive perineal urethrostomy in...

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