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Reconstruction of pelvic fracture urethral distraction defects (PFUDD) requires mobilization of the bulbar urethra to reach the prostatic apex. To achieve this, the bulb of the spongiosum needs to be separated from the perineal body, with division of the bulbar arteries. The distal urethral stump then becomes a flap, with retrograde irrigation from the glans and some perforating arteries. However in some cases, penile arterial supply is compromised by the pelvic fracture, resulting in penile arterial insufficiency. In such cases, ischemic necrotic failure of the urethral reconstruction has been reported. In this video we demonstrate a technique to preserve arterial blood supply to the bulb.
Bulbar artery sparing during reconstruction of pelvic fracture urethral distraction defects Gómez, Reynaldo G.Marchetti, PabloCatalan, GabrielVidal, Alvaro
InstitutionUrology Service, Hospital del Trabajador, Santiago, Chile


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