Русский
Bypass heterotopic urethroplasty as a method of possible choice in the surgical treatment of extended strictures of the posterior urethra. One concept – three clinical cases
DOI: https://dx.doi.org/10.18565/urology.2023.5.82-91
A.A. Kamalov, R.T. Adamyan, A.L. Istranov, O.I. Startseva, S.N. Zorkin, A.V. Verzin, M.M. Ekhoyan, KH.Z. Imanova, O.YU. Nesterova
1) Medical Research and Education Center of the Lomonosov Moscow State University, Moscow, Russia; 2) Sechenov First Moscow State Medical University, Moscow, Russia; 3) Petrovsky National Research Centre of Surgery, Moscow, Russia; 4) N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the NMRRC of the Ministry of Health of Russia, Moscow, Russia; 5) City Clinical Hospital 31, Moscow, Russia
Objective. To study the effectiveness of surgical treatment of extended strictures of the posterior urethra by the method of bypass heterotopic urethroplasty.
The authors present 3 patients after urethral reconstruction by the method of bypass heterotopic urethroplasty. Patients before surgery were united by the lack of patency of the posterior urethra for a significant length as a result of trauma or iatrogenic injury, as well as the need to have a cystostomy and the inability to restore the patency of the urethra by traditional methods of conservative and surgical treatment.
The patency of the urethra was restored in all patients, the cystostomy was removed, and a certain level of control of urination was achieved.
The method of bypass heterotopic urethroplasty may become the operation of choice in the treatment of hard-to-reach strictures and obliterations of the posterior urethra due to the high effectiveness of treatment. Despite the fact that the issue of incontinence remains unresolved, this method allows us to hypothesize that neosphincter mechanisms can spontaneously form in the area of anastomosis of the heterotopic urethra and the bladder wall over time.
The authors present 3 patients after urethral reconstruction by the method of bypass heterotopic urethroplasty. Patients before surgery were united by the lack of patency of the posterior urethra for a significant length as a result of trauma or iatrogenic injury, as well as the need to have a cystostomy and the inability to restore the patency of the urethra by traditional methods of conservative and surgical treatment.
The patency of the urethra was restored in all patients, the cystostomy was removed, and a certain level of control of urination was achieved.
The method of bypass heterotopic urethroplasty may become the operation of choice in the treatment of hard-to-reach strictures and obliterations of the posterior urethra due to the high effectiveness of treatment. Despite the fact that the issue of incontinence remains unresolved, this method allows us to hypothesize that neosphincter mechanisms can spontaneously form in the area of anastomosis of the heterotopic urethra and the bladder wall over time.
Keywords: radial flap, groin flap, heterotopic urethroplasty, urethral reconstruction, urethral strictures
About the Autors
Corresponding author: O.Y. Nesterova – PhD (Med), Urologist, Researcher, Urology and Andrology Unit, Medical Research and Education center, Lomonosov Moscow State University, senior lecturer of the Dept. of Urology and Andrology, Faculty of Fundamental Medicine Lomonosov Moscow State University. Moscow, Russia; e-mail: oy.nesterova@gmail.com
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