Perineostomy – Perineal Urostomy

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Opening of the posterior Urethra on the Perineum

Seldom done
This procedure is performed when concentric extensive scarring in the urethra (strictures) causes Urinary Retention
A long history of strictures.
This is alternative to an invasive procedure where long periods of anaesthetic is contra-indicated and extensive grafts may be required
Usually for chronically sick patients who cannot undergo surgery, yet are active enough not to want a permanent catheter.
Patients who don’t want to / cannot do intermittent self-dilatation of these strictures
Don’t want a permanent Indwelling Catheter penile/Urethral cripple

Patients will receive a General Anaesthetic.
Flexible cystoscopy is done through your urethra or suprapubic catheter site to find normal urethra (usually posterior urethra)
A urethral sound is placed/ catheter
A perineal incision is made.
The urethra is divided proximal (above) the stricture
The opening of the urethra is brought out and attached to the skin on the perineum (the area between scrotum and anus)
A catheter is placed
Prophylactic antibiotics will be given to prevent any infections.