Reconstruction of the Female Urethra: Versatility, Complexity and Aptness

Wadie, Bassem; Elhifnawy, A.; Khair, Albair A.

doi:10.1016/j.juro.2007.01.141

Cited by 12 publications

(5 citation statements)

References 10 publications

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“…Vaginal flap and buccal mucosal graft urethroplasty were more reported and used for female urethral reconstruction, while these techniques are more suitable for female urethral stricture and small urethral loss. For long urethral defect or proximal urethral injuries bladder wall flaps can be adopted for urethroplasty [ 7 – 9 ].The female urethral replacement is mainly accomplished by anterior bladder wall (Tanagho) tube or tubularization of vaginal mucosa [ 10 ]. Tanagho was first to bring up the technique of reconstructing bladder neck with tubular anterior bladder flap in 1981 [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The muscular distribution and neuroreceptors of bladder is thought to promote continence in bladder flap urethral reconstruction [ 11 ]. In Tanagho technique and existed studies adopting the method of bladder wall flap urethroplasty, the stenosis bladder neck was transected and the fibrous tissues were completely excised, which we think might sacrifice some function of the bladder neck [ 10 , 11 , 14 , 24 ]. An intact bladder neck is crucial to continence, not only because it is where the detrusor locate at and it’s sphincteric, but also because it is where the autonomic nerve and somatic nerve converge.…”

Section: Discussionmentioning

confidence: 99%

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Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture

Jin

Shu

et al. 2020

BMC Urol

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Background Girls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap. Methods We retrospectively analysed data of 5 girls with pelvic fracture bladder neck avulsion and urethral rupture admitted to our institution from July 2017 to October 2019. They all came to our institution with a suprapubic tube. Patients’ trauma was all initially treated at other hospitals, 4 had suprapubic cystotomy and 1 had urethral realignment. One girl also had three other urethroplasties at other hospitals. We took pubectomy, posterior ureth roplasty and bladder neck reconstruction with anterior bladder wall flap in these 5 girls. Post-operative assessments included voiding cystourethrography, uroflowmetry and urethroscopy after urethral catheter removal. Verbal consent to participate was obtained from the parent or legal guardian of the children. Results Operation time ranged from 120 to 180 min. Follow-up time is 12 to 27 months. Uroflowmetry showed that maximum urine flow rate improved significantly. Cystourethrography indicated good continuity of the urethra. Two girls had urinary incontinence postoperatively but were continent 3 months later. One patient developed vesical-abdominal fistula and got repaired by surgery 6 months later. She was continent ever since. Other complications were not observed during the follow-up period. Conclusions Our method of bladder neck reconstruction using bladder flap as a patch is feasible and provides good continence, especially for those with serious bladder neck avulsion and urethral rupture caused by extensive trauma and those who had posttraumatic urethral distraction needed second repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture

Jin

Shu

et al. 2020

BMC Urol

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“…It is usually feasible to provide a single-stage reconstruction with optimal outcomes in most patients. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

Pediatric pelvic fracture urethral distraction defect causing complete urethrovaginal avulsion

et al. 2018

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Pelvic fracture with urethral injury in girls is an uncommon entity that is usually associated with concomitant vaginal lacerations. Management options vary from immediate exploration and urethral anastomosis to delayed urethroplasty. We report our experience of managing a 10-year old girl presenting 6 months after a pelvic fracture with urethrovaginal injury and a completely obliterated urethral meatus managed successfully with a single-stage bladder tube repair.

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“…Tubed vascularized flaps from the anterior bladder wall or vaginal mucosa have been well-described regional options for reconstruction that provide satisfactory results when available. 1 The vaginal flap as described by Blaivas and Purohit is a workhorse for urologic reconstructive surgeons and can be designed in various fashions depending on the urethral deficit. In a series of over 100 patients, Blaivas and Purohit reported a success rate of 93% using this technique.…”

Section: Discussionmentioning

confidence: 99%

Female Urethral Reconstruction Using a Tubed Rectus Abdominis Myocutaneous Flap

Kozlow

Chang

2012

J reconstr Microsurg

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We describe the novel use of a rectus abdominis myocutaneous flap for reconstruction of the female urethra following an oncological pelvic resection. Reconstruction of the female urethra from the bladder neck to external urethral orifice was successfully performed, avoiding the need for a urostomy. To our knowledge, the myocutaneous flap has never been described for complete urethral reconstruction.

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Reconstruction of the Female Urethra: Versatility, Complexity and Aptness

Abstract: Female urethral defects are usually complex. Congenital causes are associated with severe incontinence. Repair of such defects is challenging, yet 1-stage reconstruction is feasible and potentially successful.

Cited by 12 publications

References 10 publications

Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture

Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture

Pediatric pelvic fracture urethral distraction defect causing complete urethrovaginal avulsion

Female Urethral Reconstruction Using a Tubed Rectus Abdominis Myocutaneous Flap

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