3D laparoscopic neourethral reconstruction for iatrogenic complete loss of urethra: a case report and narrative...

Urethral injuries in females are rare, and the literature describes various surgical techniques to manage these cases. However, the reported cases were managed with open surgery. We present a case of complete loss of urethra managed using three-dimensional laparoscopy. The patient had a recent history of vaginal hysterectomy complicated by post-operative retention. Multiple urethral dilatations were performed which ultimately stopped working and the patient presented to us in a state of chronic retention. Multiple investigations including an examination under anaesthesia, micturating cystourethrogram, and surgical trans-vaginal exploration confirmed the absence of a meaningful urethra, and the patient was planned for a neourethral reconstruction. This was performed using three-dimensional laparoscopy. The neourethra was created using an anterior bladder flap. At 12 months follow-up, the patient has normal continence and voids to completion. Laparoscopic urethral reconstruction can yield good functional results and offers the known benefits of minimally invasive surgery.