Presentation Authors: Mélanie Aubé*, Montréal, Canada, Ramón Virasoro, Kurt McCammon, Norfolk, VA
Introduction: Posterior urethroplasty is the standard of care for pelvic fracture urethral injuries (PFUI). Adjunctive manoeuvres such as corporal splitting, infrapubectomy and corporal rerouting are sometimes necessary to achieve a tension-free anastomosis. Corporal rerouting is rarely necessary, therefore rarely performed. Our objective is to detail the surgical steps and technique for the above-mentioned procedures.
Methods: Our case is that of a 14-year-old boy with PFUI secondary to a motor vehicle accident. The patent was initially managed with a percutaneous suprapubic tube and underwent urethral rest for 3 months. Pre-operative combined retrograde urethrogram and antegrade flexible cystoscopy showed a 6cm distraction defect. Posterior urethroplasty was performed, using corporal splitting, infrapubectomy and corporal rerouting, as detailed in the video.
Results: The post-operative course was uneventuful and post-operative imaging perfomed 1 month later showed an open and patient urethra with no extravasation. The patient was doing well at his 6-month post-operative visit.
Conclusions: Adjunctive manoeuvres during posterior urethroplasty may be necessary to obtain a tension-free anastomosis. Knowledge of the surgical techniques is essential for successful surgical outcomes.