Urethrosphincteric reconstruction for congenitally absent urethra

Area of Science:

• Urology
• Pediatric Surgery
• Congenital Anomalies

Background:

• Congenital absence of the urethra is a rare and complex condition.
• Patients present with complete urinary incontinence due to malformations of the urogenital sinus.
• Management often requires complex reconstructive surgery or urinary diversion.

Observation:

• Three female patients with congenital urethral absence and associated complex caudal urogenital sinus anomalies were studied.
• A novel surgical technique involved creating a neourethra using an anterior bladder wall flap.
• This neourethra was positioned to replace the absent urethra.

Findings:

• The constructed neourethra contained abundant circularly oriented fibers, crucial for sphincteric function.
• The neourethra effectively provided sufficient sphincteric function to maintain urinary continence.
• All three patients achieved continence, eliminating the need for urinary diversion.

Implications:

• This bladder flap neourethra technique offers a viable solution for congenital urethral absence.
• It reconstructs functional urethral continuity and restores urinary continence.
• This approach avoids the morbidity associated with urinary diversion in complex congenital anomalies.