The Formation of a perineal urethrostomy

Rees, RW

Inflatable penile prosthesis. Erectile dysfunction, penosctotal approach

This video is a step-by step demonstration of the formation of an end-urethrostomy in the perineum for a 72-year old man with a history of recurrent penile urethral strictures, multiple endoscopic procedures and previous penile urethroplasty, who was unkeen on performing intermittent self-dilatation, and was not a candidate for further urethral reconstruction.

Following an original description by Blandy in 1968, an inverted U-shaped incision is performed in the perineum, and the urethra exposed and mobilised. The urethra is then transected and the distal end oversewn. The ventral aspect of the urethra is then spatulated and the urethrostomy is then formed by suturing the U-flap into the spatulation using interrupted sutures, followed by suturing of the upper flap onto the dorsal aspect of the urethra. The skin incisions are then closed and a catheter placed for 14 days.

The author has nothing to disclose

None

1. Blandy JP, Singh M, Tresidder GC. Urethroplasty by scrotal flap for long urethral strictures. Br J Urol. 1968;40(3):261–7.
2. DeLong J, McCammon K, Capiel L, et al. Augmented perineal urethrostomy using a dorsal buccal mucosal graft, bi-institutional study. World J Urol. 2017;35(8):1285–90.