Artificial Urinary Sphincter in a High-Risk Urethra: Transcorporal Gullwing Modification Description of the Technique.

IF 1 Q4 UROLOGY & NEPHROLOGY
David Hernández-Hernández, María Yanira Ortega-González, Bárbara Padilla-Fernández, David Manuel Castro-Díaz
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Abstract

Background: In this report, we describe a modification of transcorporal artificial urinary sphincter place ment known as Gullwing modification.

Description of technique: Using a penoscrotal approach, bilateral corpora cavernosa flaps are harvested and sutured in the midline covering the lateral and ventral surfaces of the urethra. Transcorporal cuff placement provides dorsal reinforcement, thus having extra tissue buttressing all the circumference in cases of a fragile urethra due to previous urethral cuff erosion, urethroplasty, or pelvic radiotherapy.

Patient and methods: After previous urethral cuff erosion, radiotherapy, and urethral reconstruction, our patient complained of severe stress urinary incontinence. Due to the high risk of urethral complications, we proceed to a transcorporal artificial sphincter placement with urethral reinforcement through a bilateral cavernosal flap.

Results: The surgery was successfully completed, and after 6 weeks, sphincter was activated with satisfac tory results. Two years after surgery, his continence status is stable without complications.

Conclusion: Urethral complications associated with artificial urinary sphincter surgery remain a challenge for the reconstructive surgeon. Reinforcement of the ventral aspect of the urethra through corpora cavernosal flaps may reduce the likelihood of urethral erosion in high-risk cases.

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人工尿道括约肌在高危尿道:经下体鸥翼修饰技术描述。
背景:在本报告中,我们描述了一种经体外人工尿道括约肌置换术的改良,称为Gullwing改良术。技术描述:采用阴囊入路,取双侧海绵体皮瓣,缝合于覆盖尿道外侧和腹侧表面的中线。经尿道袖带放置提供了背部加固,因此,在由于先前尿道袖带糜烂、尿道成形术或盆腔放疗而导致尿道脆弱的情况下,有额外的组织支撑整个尿道周长。患者和方法:我们的患者在既往尿道套糜烂,放疗和尿道重建后,主诉严重的应激性尿失禁。由于尿道并发症的高风险,我们进行经膀胱人工括约肌置入,并通过双侧海绵体皮瓣加强尿道。结果:手术顺利完成,6周后,括约肌激活,效果满意。术后2年,患者尿失禁状况稳定,无并发症。结论:人工尿道括约肌手术相关的尿道并发症仍然是尿道重建外科医生面临的一个挑战。通过海绵体皮瓣加强尿道腹侧可以减少高危病例尿道糜烂的可能性。
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来源期刊
Turkish journal of urology
Turkish journal of urology Medicine-Urology
CiteScore
2.10
自引率
0.00%
发文量
53
期刊介绍: The aim of the Turkish Journal of Urology is to contribute to the literature by publishing scientifically high-quality research articles as well as reviews, editorials, letters to the editor and case reports. The journal’s target audience includes, urology specialists, medical specialty fellows and other specialists and practitioners who are interested in the field of urology.
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