Introduction and Objective:
Severe trauma involving female urethra is dreadful. Restoration of the anatomical integrity is never enough without keeping an acceptable degree of continence as well. Many staged procedures were described to achieve this goal but one stage reconstruction was also reported with remarkable success . This video demonstrates one stage repair of a severe form of urethral tissue loss.
Patients and Methods:
This video shows a case of 25- year old woman who had an obstructed labor, ended by massive urethral bladder neck disruption and total incontinence is demonstrated in this video.
Dorsal urethral plate was intact. Reconstruction was planned so that this healthy part is made use of. A pedicled vaginal flap was harvested to replace the ventrum of the urethra, and was anastmosed to the dorsal flap. Bladder neck was adherent to the back of symphysis, so it was severed and reanastmosed to the dorsal urethral wall. Rectus fascia sling was utilized to accomplish continence.
Results:
Postoperative course was uneventful. 6 Months after surgery, the patient is dry day and night. The patient was instructed to adopt Valsalva’s maneuver during voiding.
Vaginal lumen was wide enough to allow for normal intercourse without reported dyapareunia.
Conclusion:
One stage reconstruction of complex female urethral injury is technically demanding and is potentially successful, provided that different techniques of reconstruction and anti-incontinence procedures are at hand.
Referneces:
InstitutionUrology and Nephrology Center, Mansoura, Egypt
-
One stage reconstruction of the ...
One stage reconstruction of the urethra and bladder neck, followi...
Duration00:07:57 Created2010-10-09 16:10:01 -
The reconstruction of complete u...
The reconstruction of complete urethral stricture with buccal muc...
Duration00:08:45 Created2010-05-17 16:37:48 -
Posterior urethroplasty using a ...
Posterior urethroplasty using a combined surgical and endoscopica...
Duration00:07:19 Created2009-12-29 11:40:21 -
Bulbar artery sparing during rec...
Bulbar artery sparing during reconstruction of pelvic fracture ur...
Duration00:08:16 Created2010-07-21 06:14:09 -
Endoscopic realignement and subs...
Endoscopic realignement and subsequent surgical repair of total m...
Duration00:07:31 Created2009-10-05 21:38:02 -
Posterior urethroplasty for comp...
Posterior urethroplasty for complicated strictures - "prerec...
Duration00:07:10 Created2010-11-25 11:03:23 -
Management of rectourinary fistu...
Management of rectourinary fistulas: The York Mason Approach (SIU...
Duration00:06:51 Created2010-11-30 11:40:53 -
Injury of renal artery during ro...
Injury of renal artery during robotic partial nephrectomy
Duration00:05:35 Created2009-10-07 11:25:29 -
Technique of robot assisted vesi...
Technique of robot assisted vesicovaginal fistula repair
Duration00:07:05 Created2009-10-09 05:32:08 -
Iatrogenic diaphragmatic lesion:...
Iatrogenic diaphragmatic lesion: laparoscopic repair
Duration00:07:03 Created2009-10-08 13:18:16 -
Anastomotic posterior urethroplasty
Anastomotic posterior urethroplasty
Duration00:08:27 Created2010-07-10 11:51:12 -
Real life - managing complicatio...
Real life - managing complications in laparoscopy
Duration00:02:15 Created2009-10-25 18:09:03 -
NOTES approach to management of ...
NOTES approach to management of inadvertent splenic, enteral and ...
Duration00:04:55 Created2009-10-05 22:41:44 -
One-sided urethral dissection fo...
One-sided urethral dissection for full length stricture
Duration00:09:31 Created2010-01-08 11:32:18









There are no comments available yet.