The new transperineal-prerectal approach in posterior urethroplasty.
OBJECTIVE
A new posterior urethroplasty is suggested for patients with pelvic fracture urethral distraction defect (PFUDD).


METHODS
12 men, with PFUDD were treated with an anastomotic urethroplasty, using a transperineal-prerectal approach. All patients had a suprapubic tube in place and were impotent after pelvic trauma. The goal of this approach was to facilitate an extensive removal of the scar tissues around the prostatic apex to promote successful bulbo-prostatic anastomosis.


RESULTS
No patients had intraoperative, perioperative or postoperative complications. Urinary incontinence or rectourethral fistula was never observed. In 11 patients the postoperative mean peak flow was 20 ml/sec. The recurrence of the stricture occurred in 1 patient.


CONCLUSIONS
The transperineal-prerectal approach to the posterior urethra facilitated a free tension posterior end-to-end anastomosis, as an alternative to the transpubic anastomotic procedure.
Austoni
Edoardo
E
Department of Urology, University of Milan, San Giuseppe Hospital, Milan, Italy.
Guarneri
Andrea
A
Colombo
Fulvio
F
Palminteri
Enzo
E
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000293:injuries / Q000601:surgery; D010502:Perineum / Q000601:surgery*; D012007:Rectum; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods