The new transperineal-prerectal approach in posterior urethroplasty.
uretra, stenosi uretrale
Austoni E, Guarneri A, Colombo F, Palminteri E.
The new transperineal-prerectal approach in
posterior urethroplasty.
Arch Ital
Urol Androl. 2005 Jun;77(2):122-4.
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.
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