Abstract
Objective:
To describe a step-by-step guide for successful implementation of transmeatal urethral surgery for obliterated membranous urethral strictures.
Patient and Methods:
The patient is placed in the dorsal lithotomy position. Cystoscopy will be performed through both the suprapubic tube above and transmeatally from below. A Libri rigid endoscopic needle will be passed under guidance, with placement of a 0.38 wire through the inner lumen. Subsequently, over the wire, a tiger tail catheter will be placed and the wire exchanged for a rigid sensor wire, over which a charger balloon will be passed and used for dilation. The Olympus resectoscope will be used to resect the area of the stricture. The RD180 from LSI solutions will be used to situate the graft over the area of the stricture.
Results:
Our number of cases is five, of which 4 have had no recurrence. The median follow-up is 6 months. We have three from radiation and two from pelvic fractures. In the radiation population, one patient did recur. However, he was not obliterated and has been voiding even though he has a 14 French urethra.
Conclusion:
This technique appears to be a safe and effective repair option for management of obliterated membranous urethra strictures.
Author disclosure statement: J.N.W. is a consultant for Olympus. The other authors have no conflicts of interest to disclose.
Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure
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Runtime of video: 7 min 38 sec.