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Techniques of urethroplasty in Yeshawanthpur, Bangalore

All techniques of urethroplasty

All techniques of urethroplasty in Yeshawanthpur

Techniques of urethroplasty in Yeshawanthpur, Bangalore is a surgical procedure used to repair the urethra, the internal tube that transfers urine out of your body. Manipal Hospital, Yeshwanthpur, provides modern techniques to successfully carry out a urethroplasty procedure.

What is it?

Injury to the posterior urethra can present a number of reconstructive issues due to its complicated architecture. Surgical repair can be quite successful with the right operating planning and skill. The procedures for the perineal approach to posterior urethral stenosis discussed in this review include bulbomembranous anastomosis for pelvic fracture urethral damage and repair of vesicourethral anastomotic stenosis (VUAS) following prostate surgery. The advanced techniques discussed include a bulbar artery sparing approach to posterior urethroplasty and an intrasphincteric urethroplasty procedure that may allow patients with membranous urethral stenosis to maintain continence.

Urethroplasty for pelvic fracture urethral injuries

For many years, it was widely assumed that pelvic fracture caused harm to the posterior urethra at the prostatomembranous junction. However, current information suggests that the majority of injuries occur near the bulbomembranous junction. The membrane urethra's close closeness to the pubic rami and symphysis, urethral fixation via the puboprostatic ligaments and urogenital diaphragm, and a lack of supporting prostatic or spongiosal tissue all contribute to bulbomembranous junction injury. As a result, posterior urethroplasty for PFUI is more correctly referred to as a bulbomembranous anastomosis.

BMA preparations

Bulbomembranous anastomosis is the usual surgical strategy for PFUI stenosis or obliteration reconstruction, however optimal surgical approach and technique selection necessitates careful preoperative examination.

The BMA method

Positioning of the patient For BMA, the standard lithotomy position is commonly used. Many centres recommend using the exaggerated lithotomy position because it provides better and more direct perineal exposure. Exaggerated lithotomy position is related with neuropraxia, lower limb damage, and potentially rhabdomyolysis and abrupt renal failure, according to accumulating data. The use of a beanbag without adequate gel padding, as well as operations lasting more than 5 hours, increase the risk of complications related to exaggerated lithotomy.

Bulbomembranous anastomosis

The urethra is transected and scarred tissues are dissected until the healthy proximal urethral margins are discovered. To assist dissection, a curved sound is sent into the proximal urethra via the suprapubic tract. Each urethral end should be free of fibrosis, have healthy-looking mucosa, and be able to fit a 28 French bougie for the best results. The most difficult aspect of this procedure is the removal of post-traumatic perineal fibrosis. The pelvic hematoma resorption generates a dense fibrous scar in the perineum that must be completely excised. The fundamental reason of reconstructive failure is most likely an insufficient removal of scar tissue from the free urethral ends. Once the anastomosis is clear of fibrosis, six 5-0 monofilament absorbable sutures are put circumferentially and knotted in a parachute fashion. Book an appointment at Manipal Hospitals now.

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