The combined perineo-abdominal transpubic urethroplasty

Area of Science:

• Urology
• Surgical Techniques

Background:

• Pelvic fracture urethral injury (PFUI) presents complex reconstructive challenges.
• Traditional approaches may be limited in cases of long urethral gaps or associated intra-abdominal complications.

Purpose of the Study:

• To detail the operative technique of the perineo-abdominal transpubic approach for PFUI.
• To highlight indications and benefits of this combined surgical strategy.

Main Methods:

• The procedure begins with perineal exposure and mobilization of the bulbar urethra.
• Abdominal exposure is utilized only if a tension-free anastomosis is not achievable via the perineal route.
• An omental wrap is routinely employed to protect the anastomosis from fibrosis and callus.

Main Results:

• The combined approach provides wide exposure for bulboprostatic urethral anastomosis.
• Success rates are consistently high, typically 98-100%.
• Long-term durability of the repair is demonstrated.

Conclusions:

• The perineo-abdominal transpubic approach is an effective method for managing complex PFUI.
• This technique facilitates tension-free anastomosis and offers excellent long-term outcomes.