Perineal Fixation Stenting for Urethral Strictures: A Comparative Prospective Study

Objective. Comparative evaluation of the efficacy and safety of a new perineal urethral stent fixation technique versus traditional surgical approaches for urethral strictures. Materials and Methods. A prospective cohort study included 120 patients with urethral strictures ≤3 cm, randomized into 4 groups: internal optical urethrotomy (IOU), IOU+Allium BUS-80 stent, IOU+stent with perineal fixation, urethro-urethral anastomosis. Outcomes were assessed at 3 and 12 months using IPSS, QoL, Qmax and complication rates (Clavien-Dindo). Statistical analysis was performed in SPSS 26.0. Results. The perineal fixation group showed superior functional outcomes (Qmax 16.9±3.3 mL/s), comparable to urethroplasty (p=0.854) and significantly better than IOU alone (11.5±5.1 mL/s, p<0.001). The complication rate was 16.7% versus 46.7% for standard stenting (p=0.0269). In particular, no cases of stent migration or recurrence were observed during 12-month follow-up. Conclusions. Perineal stent fixation demonstrates efficacy comparable to urethroplasty with significantly less invasiveness and a better safety profile. These findings suggest that this technique is preferable for urethral stricture treatment, especially in high-risk patients.