Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Dec;39(4):244-8.
doi: 10.5152/tud.2013.061.

The use of suprapubic cystoscopy in perineal urethroplasty

Rahim Horuz  1 , Cemal Göktaş  2 , Ali Cihangir Çetinel  2 , Oktay Akça  2 , Ahmet Selimoğlu  2 , Selami Albayrak  1
Affiliations

The use of suprapubic cystoscopy in perineal urethroplasty

Rahim Horuz et al. Turk J Urol. 2013 Dec.

Abstract

Objective: Posterior urethral strictures are difficult cases to treat for urologists. Anastomotic open urethroplasty is the major surgical treatment option, and various modifications/manipulations to the procedure have been recommended in the literature. We aimed to assess the advantages of performing antegrade endoscopy through the suprapubic cystostomy tract during perineal urethroplasty.

Material and methods: Thirty-six perineal urethroplasties combined with suprapubic cystoscopy were performed in 33 adult male patients between 2005 and 2011. Pre-and peri-operative records of the patients were evaluated, with a particular focus on suprapubic cystoscopy findings during urethroplasty.

Results: The mean patient age was 41 years, and the mean lesion length was 2.6 cm (range 1-10 cm). Lesions were secondary to pelvic trauma in 21 patients, to a history of prostatic surgery in 8 patients, and to other miscellaneous causes in the 4 remaining patients. In 23 cases with normal bladder necks, the anastomosis was created under the guidance of antegrade cystoscopy with fluoroscopy. In 10 cases, stiff guide wires or paddles were used in addition to endoscopic light to identify the correct anastomosis site. In two procedures, fistula openings were identified during endoscopy, and fistula repair was performed along with anastomosis. In one case involving the longest lesion with involvement of the bladder neck, a combined perineal-transpubic urethroplasty was performed. The mean follow up duration was 19 (3-38) months. The overall success rate was 91%, and the re-operation rate was 9%.

Conclusion: Suprapubic cystoscopy is an easy-to-perform adjunctive modality in perineal urethroplasty. This method provides the benefits of supplementary endoscopic findings and feasibility of certain maneuvers that facilitate debridement and anastomosis formation concurrent with perineal urethroplasty.

Keywords: Anastomosis; cystoscopy; perineum; suprapubic; urethral stricture.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
View of a guide wire passed in an antegrade manner through a cystoscope and pulled out from the perineal side
Figure 2.
Figure 2.
Antegrade endoscopic view of a false route. Inserting a needle from the perineal side and advancing into the bladder may prevent poor alignment during anastomosis
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • [Diagnostic workup of urethral strictures].
    Chaloupka M, Beck V, Kretschmer A, Tritschler S, Stief CG, Strittmatter F. Chaloupka M, et al. Urologe A. 2018 Jan;57(1):6-10. doi: 10.1007/s00120-017-0547-5. Urologe A. 2018. PMID: 29189873 Review. German.

References

    1. Koraitim MM. The lessons of 145 post-traumatic posterior urethral strictures treated in 17 years. J Urol. 1995;153:63–6. - PubMed
    1. Mundy AR. Urethroplasty for posterior urethral strictures. Br J Urol. 1996;78:243–7. - PubMed
    1. Turner Warwick R. Principles of urethral reconstruction. In: Webster G, Kirby R, King L, Goldwasser B, editors. Reconstructive urology. Blackwell Cambridge, Massachusetts; 1993. pp. 609–42.
    1. Turner Warwick R. Prevention of complications resulting from pelvic fracture urethral injuries-and from their surgical management. Urol Clin North Am. 1989;16:335–8. - PubMed
    1. Andrich DE, Dunglison N, Greenwell T J, Mundy AR. The long-term results of urethroplasty. J Urol. 2003;170:90–2. - PubMed

LinkOut - more resources