Transperineal bulbo-prostatic anastomotic urethroplasty.
Transperineal bulbo-prostatic anastomotic urethroplasty is the procedure of choice for the treatment of pelvic-fracture urethral distraction defects. Surgery is usually performed at 3-6 months after the injury. Endoscopic urethroplasty may prove to be an alternative if long-term follow-up confirms the initial enthusiasm for the procedure. Alternative urethroplasty techniques have not proved appropriate in long-term follow-up. The procedure depends on a progressive series of steps to capitalise on the elastisity of the urethra and then straighten out the natural curve of bulbar urethra. A retropubic or (truly) transpubic approach is rarely necessary except for complicated problems. The restricture rate is approximately 10% and is generally associated with poor vascularity. Other complications are generally the complications of the original injury rather than of the procedure itself.
Department of Urology, Guy's Hospital, London, UK.
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Mundy
D000714:Anastomosis, Surgical; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D010388:Pelvis / Q000293:injuries; D011182:Postoperative Care; D011379:Prognosis; D011467:Prostate / Q000601:surgery*; D012008:Recurrence; D014521:Urethra / Q000293:injuries / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*