Realignment of damaged membranous urethra Simplified technique

SURGEON’S WORKSHOP

REALIGNMENT

OF DAMAGED

MEMBRANOUS

URETHRA

Simplified Technique LORNE

D. SULLIVAN,

M.D.

Vancouver, British Columbia, Canada

The management of disruption of the membranous urethra is controversial, with realignment of the urethra a major difference in the various forms of treatment advocated. We believe that realignment of the urethra is desirable and present a simplified technique to aid the urologic surgeon in this procedure. For incomplete lesions, the simple technique of dilatation of the prostatic fossa with an index finger (Fig. l), followed by the gentle guidance

into the bladder by traction on the ligature with a long curved forceps (Fig. 2). This ligature obviates the need for wide opening of the forceps in the prostatic fossa. Two suction tips aid in visualization of the catheter and ligature. Once the catheter is brought across the urethra and the gap bridged, a Foley catheter may then be sewn to the penile end and easily brought into the bladder. Vest sutures and suprapubic catheter drainage are then placed.

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FIGURE 1. Dilatation finger.

of prostatic

fossa with in&x

of a well-lubricated sound or Foley catheter on a stilet into the bladder provides a fast, safe technique and provides realignment and splinting of the urethra. Complete tears are managed by passing an 8 F catheter with an attached ligature along the anterior urethra and then drawing the catheter

540

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%

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FIGURE 2. Drawing catheter into bladder tion on ligature with curved fn-ceps.

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by trac-

This method for prostatic relocation may prevent strictures in many cases and may minimize the stricture length, thus, facilitating subsequent urethroplasty. 888 West 8th Avenue Vancouver,B.C, V52 3Yl

UROLOGY

! MAY 1979 i VOLUMEXIII, NUMBER5