Vesical exstrophy: repair using radical mobilisation of soft tissues

摘要: By more radical mobilisation of both internal and external sphincter muscles the bladder urethra than has hitherto been undertaken, physiological continence urine achieved in patients with vesicourethral exstrophy. The purpose this paper is to describe surgical technique used type regarded as classic anomaly, though principles apply all variants males females. key features are relevant second stage a three-stage procedure. periosteum on inner sides ischium pubis attachments involuntary voluntary pudendal vessels nerves mobilised so that these outstretched can be converted into wrap around newly constructed “membranous” without need for iliac or pubic osteostomy. This new made from urethral plate, which uplifted its bed dorsum penis, rotated posteriorly between crura, hinged proximally at level verumontanum, tubularised, relocated within grasp complex. necessitates construction an interim penoscrotal urethrostomy prior penile urethroplasty. rating far 19 73%. identification localisation latent but effective muscle complex situated deep pelvis totally separated dorsal plate male urethrovaginal outlet female formed basis rationale soft-tissue technique.