Transpubic Access Using Pedicle Tubularized Labial Urethroplasty for the Treatment of Female Urethral Strictures Associated with Urethrovaginal Fistulas.

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Transpubic Access Using Pedicle Tubularized Labial Urethroplasty for the Treatment of Female Urethral Strictures Associated with Urethrovaginal Fistulas Secondary to Pelvic Fracture Yue-Min Xu, Ying-Long Sa, Qiang Fu, Jiong Zhang, Hong Xie, San-Bao Jin European Urology Volume 56, Issue 1, Pages 193-200 (July 2009) DOI: 10.1016/j.eururo.2008.04.046 Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 1 (a) A severe pelvic fracture (arrow). (b,c) Cystourethrography demonstrated an urethrovaginal fistula in median urethra. (d) 5 mo postoperation, a patency of the urethra, retrograde urethrogram. (e) Voiding urethrogram. European Urology 2009 56, 193-200DOI: (10.1016/j.eururo.2008.04.046) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 2 A segment of pubic bone was removed with the Gigli saw. European Urology 2009 56, 193-200DOI: (10.1016/j.eururo.2008.04.046) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 3 (a) The urethral defect measured 3cm in length; arrows indicate the urethrovaginal fistula. (b) The urethrovaginal fistula was sutured. European Urology 2009 56, 193-200DOI: (10.1016/j.eururo.2008.04.046) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 4 (a) A flap of appropriate size and shape was mobilized on its vascular pedicle. (b) The flap was tubularized over a fenestrated silicone stent with continual 5-zero polyglactin sutures. European Urology 2009 56, 193-200DOI: (10.1016/j.eururo.2008.04.046) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 5 (a) The flaps were marked on the skin of the labia minora. (b) The flap was mobilized on its vascular pedicle. (c) Two flaps were pieced together with 5-zero polyglactin continual sutures. (d) The flap was tubularized with 5-zero polyglactin continual sutures. European Urology 2009 56, 193-200DOI: (10.1016/j.eururo.2008.04.046) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 6 An end-to-end anastomosis was performed between the normal urethra and neourethra, and the rectus muscle flap (arrow) was wrapped around the anastomosis. European Urology 2009 56, 193-200DOI: (10.1016/j.eururo.2008.04.046) Copyright © 2008 European Association of Urology Terms and Conditions