case_images: PMC10836446_01
case_images: (a) Combined retrograde urethrogram and micturating cystourethrography depicting the length of the defect. (b) Pericatheter study depicting no leakage from the tubularized flap. (c) Postoperative micturating cystourethrography delineating the tabularized flap
case_images: IJU-40-62-g001.jpg
case_images: PMC10836446_01_IJU-40-62-g001.jpg
case_images: iju.iju_329_23-f001
case_images: He underwent a retrograde urethrography and micturating cystography, which revealed a long segment defect involving the bulbar urethra, with normal penile and prostatic urethra suggestive of ischemic bulbar urethral necrosis [Figure 1a]. A pericatheter dye study was performed after 3 weeks which showed no leak, and per-urethral catheter was removed [Figure 1b and c].
case_images: (a) Intraoperative image showing the long segment defect (Blue arrow-distal end at proximal bulbar urethra, Green arrow: Proximal end at bulbomembranous junction). (b) Preputial flap of adequate length harvested and transposed into the perineum (Blue arrow-preputial graft). (c) Preputial graft anastomosed to a distal end and being tabularized over a 16Fr silicone Foley catheter (Blue arrow). (d) Tubularized flap being anastomosed to the proximal end by parachute technique. (e) Completed anastomosis
case_images: IJU-40-62-g002.jpg
case_images: PMC10836446_01_IJU-40-62-g002.jpg
case_images: iju.iju_329_23-f002
case_images: After urethral mobilization, there was a 10 cm long defect extending from the bulbo-membranous junction to the penobulbar junction, and the whole of the bulbar urethra had undergone ischemic necrosis [Figure 2a]. The flap was tubularized over a 16Fr silicone Foley catheter passed through the meatus and the flap was then anastomosed to the penile urethra in a continuous fashion [Figure 2b and c]. The proximal end of the tube was anastomosed to the membranous urethra with 10 interrupted sutures using the parachute technique [Figure 2d and e].