Treatment of patients with anterior urethral strictures: the role of perineal urethrostomy

Abstract

The article reviews the 2000-2020 literature on the use of perineal urethrostomy in the treatment of patients with anterior urethral strictures. Historical issues of the development of urethrostomy techniques are considered. The algorithms to choose the method of treatment of urethral strictures in favor of perineal urethrostomy are highlighted, according to the guidelines of the world's professional urological associations. The performance indicators of perineal urethrostomy were studied considering the age characteristics of the patients, the etiological genesis of the strictures, their length and location, as well as depending on the surgical technique and the follow-up period. Considerable attention is paid to studies devoted to the analysis of the functional results of urethrostomy, as well as the quality of life of patients associated with urination and sexual activity. Data are presented on the incidence of early and late surgical complications, including urethrostomy stenosis, as one of the most common. An analysis of studies evaluating factors that negatively affect the outcome of surgery was carried out. The main reasons for the growing demand for the technique in surgery for complex anterior urethral strictures and the importance of the technique among other treatment methods are discussed.