Neourethra: a new two-stage procedure for reconstruction of the functional urethra.
In 14 male dogs, the functional urethra was replaced by a bladder flap tube in a 2-stage procedure. In the 1st stage of the operation a bipedicle strip from the anterior bladder wall was tubularized around a 10F or 12F catheter. After 10 to 12 weeks the 2nd stage of the procedure was performed: the bladder neck was transected and sutured, and the cranial pedicle of the bipedicle tube was transected and pulled through the bluntly dissected pelvic floor muscles. From the distal end of the tube a perineal urostoma was created to facilitate radiological and urodynamic followup. Eight dogs completed a followup 5 months after the 2nd procedure. Urodynamic and x-ray studies were done preoperatively, after the 1st, and twice after the 2nd operation. All dogs were continent as a result of a mean functional urethral length of 8 cm. with a maximum closure pressure of 82.9 cm. H2O. Closure pressure was related to the tone of the smooth muscular tube and additional compression of the tube by the pelvic floor muscles. The method is considered to be applicable in cases of congenital defects or total loss of the functional urethra.
D000818:Animals; D002404:Catheterization / Q000295:instrumentation; D004285:Dogs; D008297:Male; D011312:Pressure; D013524:Surgical Flaps; D014521:Urethra / Q000502:physiology / Q000601:surgery*; D001743:Urinary Bladder / Q000502:physiology / Q000601:surgery; D014549:Urinary Incontinence / Q000601:surgery; D014563:Urodynamics