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• W2912750266 abstract "No AccessJournal of UrologyAdult Urology1 May 2019Urinary and Sexual Function after Perineal Urethrostomy for Urethral Stricture Disease: An Analysis from the TURNSThis article is commented on by the following:Editorial CommentEditorial Comment Gregory P. Murphy, Kirkpatrick B. Fergus, Thomas W. Gaither, Nima Baradaran, Bryan B. Voelzke, Jeremy B. Myers, Bradley A. Erickson, Sean P. Elliott, Nejd F. Alsikafi, Alex J. Vanni, Jill C. Buckley, and Benjamin N. Breyer Gregory P. MurphyGregory P. Murphy *Correspondence: Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Pl., Suite 216, Wohl Hospital, St. Louis, Missouri 63110 (telephone: 314-273-1597; e-mail: E-mail Address: [email protected]). Division of Urology, Washington University, St. Louis, Missouri More articles by this author , Kirkpatrick B. FergusKirkpatrick B. Fergus Departments of Urology, University of California-San Francisco, San Francisco More articles by this author , Thomas W. GaitherThomas W. Gaither Departments of Urology, University of California-San Francisco, San Francisco More articles by this author , Nima BaradaranNima Baradaran Departments of Urology, University of California-San Francisco, San Francisco More articles by this author , Bryan B. VoelzkeBryan B. Voelzke University of Washington, Seattle, Washington More articles by this author , Jeremy B. MyersJeremy B. Myers University of Utah, Salt Lake City, Utah More articles by this author , Bradley A. EricksonBradley A. Erickson University of Iowa, Iowa City, Iowa More articles by this author , Sean P. ElliottSean P. Elliott University of Minnesota, Minneapolis, Minnesota Financial interest and/or other relationship with Boston Scientific, PercuVision and Urotronic. More articles by this author , Nejd F. AlsikafiNejd F. Alsikafi UroPartners, Gurnee, Illinois More articles by this author , Alex J. VanniAlex J. Vanni Lahey Hospital and Medical Center, Burlington, Massachusetts More articles by this author , Jill C. BuckleyJill C. Buckley University of California-San Diego Health System, San Diego, California More articles by this author , and Benjamin N. BreyerBenjamin N. Breyer Departments of Urology, University of California-San Francisco, San Francisco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Perineal urethrostomy is a viable option for many complex urethral strictures. However, to our knowledge no comparison with anterior urethroplasty regarding patient reported outcome measures has been published. We compared these groups using a large multi-institution database. Materials and Methods: We performed a retrospective study of anterior urethroplasty in the TURNS (Trauma and Urologic Reconstructive Network of Surgeons) database. The anterior urethroplasty cohort was defined by long strictures greater than 6 cm. We compared demographic, clinical, urinary and sexual characteristics using validated patient reported outcome measures between patients treated with long stricture anterior urethroplasty and those who underwent perineal urethrostomy. Results: Of the 131 patients 92 treated with long stricture anterior urethroplasty and 39 treated with perineal urethrostomy met study inclusion criteria. The cumulative incidence of failure at 2 years was 30.2% (95% CI 18.3–47.3) for long stricture anterior urethroplasty and 14.5% (95% CI 4.8–39.1) for perineal urethrostomy (p = 0.09). Compared to baseline metrics, patients who underwent long stricture anterior urethroplasty and perineal urethrostomy had similar improvements in urinary function and stable sexual function after surgery. Conclusions: Patients reported improvement in urinary function after perineal urethrostomy with no deleterious effect on sexual function. These patient reported outcome measures were comparable to those of long stricture anterior urethroplasty. Perineal urethrostomy failure rates were similar to those of long stricture anterior urethroplasty. References 1. : SIU/ICUD consultation on urethral strictures: anterior urethra—primary anastomosis. Urology, suppl., 2014; 83: S23. Google Scholar 2. : Multivariate analysis of risk factors for long-term urethroplasty outcome. J Urol 2010; 183: 613. Link, Google Scholar 3. : Repeat urethroplasty after failed urethral reconstruction: outcome analysis of 130 patients. J Urol 2012; 188: 2260. 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Available at http://www.turnsresearch.org. Accessed November 28, 2018. Google Scholar 13. : The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992; 148: 1549. Link, Google Scholar 14. : Core Lower Urinary Tract Symptom score (CLSS) questionnaire: a reliable tool in the overall assessment of lower urinary tract symptoms. Int J Urol 2008; 15: 816. Google Scholar 15. : Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319. Google Scholar 16. : Male Sexual Health Questionnaire (MSHQ): scale development and psychometric validation. Urology 2004; 64: 777. Google Scholar 17. : The outcomes of perineal urethrostomy with preservation of the dorsal urethral plate and urethral blood supply. Urology 2011; 77: 1223. Google Scholar 18. : 7-Flap perineal urethrostomy. Transl Androl Urol 2015; 4: 51. Google Scholar 19. : Orthotopic neobladder vs. ileal conduit urinary diversion: a long-term quality-of-life comparison. Urol Oncol 2016; 34: 121.e1. Google Scholar 20. : Health-related quality of life after radical cystectomy: a cross-sectional study with matched-pair analysis on ileal conduit vs ileal orthotopic neobladder diversion. Urology 2017; 108: 82. Google Scholar 21. : Long-term health-related quality of life outcomes following radical cystectomy. Urology 2017; 106: 82. Google Scholar 22. : Perineal urethrostomy: surgical and functional evaluation of two techniques. Biomed Res Int 2015; 2015: 365715. Google Scholar 23. : Heroic measures may not always be justified in extensive urethral stricture due to lichen sclerosus (balanitis xerotica obliterans). Urology 2004; 64: 565. Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the fifth of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1018 and 1019. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLee W, Du C, Choe C, Massman J, Kim J, Lee U, Lucioni A and Kobashi K (2019) Beyond Data Capture: A Single Institutional Experience with Establishing a Pelvic Floor Surgery Web Based DatabaseUrology Practice, VOL. 7, NO. 2, (127-131), Online publication date: 1-Mar-2020.Smith J (2019) This Month in Adult UrologyJournal of Urology, VOL. 201, NO. 5, (829-830), Online publication date: 1-May-2019.Related articlesJournal of Urology8 Apr 2019Editorial CommentJournal of Urology8 Apr 2019Editorial Comment Volume 201Issue 5May 2019Page: 956-961 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsurinationpatient reported outcome measuresquality of lifeurethral strictureerectile dysfunctionMetricsAuthor Information Gregory P. Murphy Division of Urology, Washington University, St. Louis, Missouri *Correspondence: Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Pl., Suite 216, Wohl Hospital, St. Louis, Missouri 63110 (telephone: 314-273-1597; e-mail: E-mail Address: [email protected]). More articles by this author Kirkpatrick B. Fergus Departments of Urology, University of California-San Francisco, San Francisco More articles by this author Thomas W. Gaither Departments of Urology, University of California-San Francisco, San Francisco More articles by this author Nima Baradaran Departments of Urology, University of California-San Francisco, San Francisco More articles by this author Bryan B. Voelzke University of Washington, Seattle, Washington More articles by this author Jeremy B. Myers University of Utah, Salt Lake City, Utah More articles by this author Bradley A. Erickson University of Iowa, Iowa City, Iowa More articles by this author Sean P. Elliott University of Minnesota, Minneapolis, Minnesota Financial interest and/or other relationship with Boston Scientific, PercuVision and Urotronic. More articles by this author Nejd F. Alsikafi UroPartners, Gurnee, Illinois More articles by this author Alex J. Vanni Lahey Hospital and Medical Center, Burlington, Massachusetts More articles by this author Jill C. Buckley University of California-San Diego Health System, San Diego, California More articles by this author Benjamin N. Breyer Departments of Urology, University of California-San Francisco, San Francisco More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the fifth of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1018 and 1019. 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