Perineal repair of membranous urethral stricture

Membranous urethral disruption secondary to pelvic fracture often results in an obliterative stricture. Most of these lesions can be repaired by a one-stage procedure provided certain maneuvers are accomplished to facilitate approximation of the bulbar to the prostatic urethra: urethral mobilization as far proximal as the suspensory ligament of the penis, separation of the corporal bodies, excision of a wedge of the inferior surface of the pubis exposed by corporal body separation, and on occasion, routing of the mobilized urethra around the corporal body. With these methods, even lengthy defects can be bridged to create a tension-free anastomosis.