Abstract：
UNASSIGNED: There is a paucity of long-term objective and patient-reported outcomes after definitive perineal urethrostomy for complex urethral strictures. Our objective is to determine comprehensive long-term success of perineal urethrostomy with our 15-year experience at a reconstructive referral center.
UNASSIGNED: Patients who underwent perineal urethrostomy between 2009 and 2023 were identified. A comprehensive long-term follow-up was conducted, evaluating both objective outcomes (retreatment-free survival) and subjective outcomes through the use of validated questionnaires. Additionally, to provide further context for our findings, we conducted a scoping review of all studies reporting outcomes following perineal urethrostomy.
UNASSIGNED: Among 76 patients, 55% had iatrogenic strictures, with 82% previously undergoing urethral interventions. At a median follow-up of 55 months, retreatment-free survival was 84%, with 16% of patients experiencing perineal urethrostomy recurrent stenosis. Patient-reported outcomes revealed a generally satisfactory voiding function (Urethral Stricture Surgery patient-reported outcome measure Lower Urinary Tract Symptoms score) and continence (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form), with median scores of 4 (range 0-24) and 0 (range 0-21), but with bimodal distributions of sexual function scores (median International Index of Erectile Function-Erectile Function domain: 3.5; median Male Sexual Health Questionnaire-Ejaculation Scale: 21). Treatment satisfaction was very high with a median International Consultation on Incontinence Questionnaire-Satisfaction outcome score of 21 (range 0-24). The scoping review revealed varying success rates ranging from 51% to 95%, highlighting difficulties in comparison due to variable success definitions and patient case mix.
UNASSIGNED: Perineal urethrostomy provides effective treatment for complex anterior urethral strictures, with high patient satisfaction, preserved continence function, and favorable voiding outcomes. It presents a viable option for older and comorbid patients, especially after thorough counseling on expected outcomes and potential risks.
UNASSIGNED: Patients who underwent perineal urethrostomy between 2009 and 2023 were identified. A comprehensive long-term follow-up was conducted, evaluating both objective outcomes (retreatment-free survival) and subjective outcomes through the use of validated questionnaires. Additionally, to provide further context for our findings, we conducted a scoping review of all studies reporting outcomes following perineal urethrostomy.
UNASSIGNED: Among 76 patients, 55% had iatrogenic strictures, with 82% previously undergoing urethral interventions. At a median follow-up of 55 months, retreatment-free survival was 84%, with 16% of patients experiencing perineal urethrostomy recurrent stenosis. Patient-reported outcomes revealed a generally satisfactory voiding function (Urethral Stricture Surgery patient-reported outcome measure Lower Urinary Tract Symptoms score) and continence (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form), with median scores of 4 (range 0-24) and 0 (range 0-21), but with bimodal distributions of sexual function scores (median International Index of Erectile Function-Erectile Function domain: 3.5; median Male Sexual Health Questionnaire-Ejaculation Scale: 21). Treatment satisfaction was very high with a median International Consultation on Incontinence Questionnaire-Satisfaction outcome score of 21 (range 0-24). The scoping review revealed varying success rates ranging from 51% to 95%, highlighting difficulties in comparison due to variable success definitions and patient case mix.
UNASSIGNED: Perineal urethrostomy provides effective treatment for complex anterior urethral strictures, with high patient satisfaction, preserved continence function, and favorable voiding outcomes. It presents a viable option for older and comorbid patients, especially after thorough counseling on expected outcomes and potential risks.
摘要：
■对于复杂的尿道狭窄，确定性会阴尿道造口术后，缺乏长期客观和患者报告的结果。我们的目标是根据我们在重建转诊中心15年的经验，确定会阴尿道造口术的长期成功。
■确定了在2009年至2023年之间进行会阴尿道造口术的患者。进行了全面的长期随访,通过使用经过验证的问卷评估客观结果(无再治疗生存期)和主观结果。此外,为我们的发现提供进一步的背景，我们对所有报告会阴尿道造口术后结局的研究进行了范围审查.
■在76名患者中，55%有医源性狭窄，82%的人以前接受过尿道干预。在中位随访55个月时，无再治疗生存率为84%,16％的患者经历会阴尿道造口术复发性狭窄。患者报告的结果显示排尿功能（USSPROMLUTS评分）和尿失禁（ICIQ-UISF）总体令人满意，中位数为4分（范围0-24）和0分（范围0-21），但性功能评分呈双峰分布（IIEF-EF中位数：3.5；MSHQ-Ej中位数：21）。治疗满意度非常高，ICIQ-满意度结果评分中位数为21分（范围0-24）。范围审查显示，成功率从51%到95%不等，突出了由于不同的成功定义和患者病例组合而导致的比较困难。
■会阴尿道造口术为复杂的前尿道狭窄提供了有效的治疗方法，患者满意度高,保留失禁功能，和有利的排尿结果。它为老年和合并症患者提供了一个可行的选择，特别是在对预期结果和潜在风险进行全面咨询之后。
■确定了在2009年至2023年之间进行会阴尿道造口术的患者。进行了全面的长期随访,通过使用经过验证的问卷评估客观结果(无再治疗生存期)和主观结果。此外,为我们的发现提供进一步的背景，我们对所有报告会阴尿道造口术后结局的研究进行了范围审查.
■在76名患者中，55%有医源性狭窄，82%的人以前接受过尿道干预。在中位随访55个月时，无再治疗生存率为84%,16％的患者经历会阴尿道造口术复发性狭窄。患者报告的结果显示排尿功能（USSPROMLUTS评分）和尿失禁（ICIQ-UISF）总体令人满意，中位数为4分（范围0-24）和0分（范围0-21），但性功能评分呈双峰分布（IIEF-EF中位数：3.5；MSHQ-Ej中位数：21）。治疗满意度非常高，ICIQ-满意度结果评分中位数为21分（范围0-24）。范围审查显示，成功率从51%到95%不等，突出了由于不同的成功定义和患者病例组合而导致的比较困难。
■会阴尿道造口术为复杂的前尿道狭窄提供了有效的治疗方法，患者满意度高,保留失禁功能，和有利的排尿结果。它为老年和合并症患者提供了一个可行的选择，特别是在对预期结果和潜在风险进行全面咨询之后。
