Single-Stage Perineal Urethroplasty for Continence in Female Epispadias: A Preliminary Report

Bhat, Abdul Rashid; Bhat, Mahakshit; Sharma, Rishi; Saxena, Gajendra

doi:10.1016/j.urology.2007.09.073

Cited by 21 publications

(21 citation statements)

References 15 publications

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“…One-stage perineal urethroplasty increases the urethral and bladder neck resistance, mainly by elongating the urethral segment and folding adjacent muscular and subcutaneous tissue [2]. It is a simple and effective method for development of both continence and cosmesis [2e4], avoiding initial abdominal surgery that could be reserved for the failure cases.…”

Section: Resultsmentioning

confidence: 99%

Complete female epispadia: The case for perineal approach

Macedo

Cruz

Trivelato

et al. 2015

Journal of Pediatric Urology

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Section: Resultsmentioning

confidence: 99%

Complete female epispadia: The case for perineal approach

Macedo

Cruz

Trivelato

et al. 2015

Journal of Pediatric Urology

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“…The surgical treatment of incontinence can be combined with the reconstruction, because the causes of these symptoms are small bladder capacity, absence of urethral resistance and bladder incompetent neck [4]. Frequently used surgical method for treating incontinence is the reconstruction of bladder neck and urethra [2,4]. The urethra must be retubularized.…”

Section: Discussionmentioning

confidence: 99%

“…The main symptom was total incontinence. For this patient a new 1-stage perineal urethrocervicoplasty was performed (as originally proposed by Young [4]) comprising of urethral reconstruction, intra-abdominal positioning of the bladder neck, and proximal urethra with a modifi ed needle suspension technique, and fi nally pelvic fl oor reconstruction. The result of operation was very good with patient achieving urinary continence 2 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment of stress urinary incontinence and vaginal prolapse for the woman with epispadia

et al. 2014

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AbstractPatient K.L., 32 years old. Menses started at thirteen years old, C 5/28. Patient had two vaginal deliveries in 2004 and 2010. Dysplasia cervicis uteri CIN2-3 was diagnosed in 2007, subsequently diathermoconisation cervicis uteri was performed. The woman was born with epispadia — extrophia of urethra to abdominal wall, without pubic bone. At the age of 8 she underwent an operation in Moscow. During the operation the neck of the bladder was formed as well as urethra, which opens in vulva, place of clitoris. When she was 8 years old, her bladder capacity was 30 ml, in teenage years — 90 ml. The patient also reported history of recurrent urinary tract infections. 2011.08.02 Patient took medical advice in out patient department Kaunas university hospital with a complaint of stress urinary incontinence: when going, coughing, sneezing, doing exercises, having sex and at rest of time. Also it was the sexual intercourse problems with orgasm. She was urinating 8 times per day but none at night. Gynecological examination: absence of pubic bone, vulva is abnormal: absence of labium major and clitoris. Urethra opens into the place of clitoris. Front and back walls of vagina are moving down (POP-Q II-III stage prolapsed). Cervix of uterus is short, epithelised (after diathermoconisation). Uterus is normal in size, in retro-versio-flexio position. — without pathology. Sonography: internal genital organs without pathology. Boney, Valsalva test are positive, Ulmstein test negative. Urodynamic study revealed a bladder capacity of 134 ml, voided volume 173 ml. Pressure of detrusor — 10cmH2O. Compliancenormal, max flow rate 13,8 ml/s, voiding time 24 s. Spontaneous contractions of detrusor were not observed. Surgical treatment: 2011.10.10 TOT (tension obturator tape). Anterior and posterior colporrhaphy and perineoplastic was performed. There were no complications during and after surgery. On the 2 day after operation patient was released from hospital.

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“…Following an initial genitoplasty procedure, a bladder neck reconstruction (BNR) is performed, typically using the YoungeDeeseLeadbetter technique or modifications thereof. Two authors have recently advocated the benefits of a single operation via a perineal approach with good functional and cosmetic outcomes [1,2]. This paper extends that experience by describing the surgical management of two girls with incontinent FE who underwent bladder neck plication, urethroplasty and genitoplasty via a perineal approach.…”

Section: Introductionmentioning

confidence: 86%