Urethral reconstruction in aphallia using transpubic exposure and colonic monti neo-urethra - An addition to the De Castro reconstruction.

Journal of Pediatric Urology
Sudipta SenCenita J Sam

Abstract

Fashioning a functioning neo urethra in a boy with aphallia is one of the unsolved problems in this condition. We present our technique and outcome of operative exposure and neo urethral construction in four aphallic boys. Retrospective study of the records of four aphallic boys operated in the period 2015-2019 was undertaken. The demographics, presentation, operative procedure, current follow up and voiding outcome was noted. The neo phallus was constructed by the De Castro technique in four aphallic boys aged 1-8 years. Pre operative assessment revealed bladder outflow obstruction in two and urinary incontinence in one boy. The operative exposure afforded after reflection of the De Castro flap was utilized in doing a limited pubic symphysiectomy. This exposed the bladder neck, urethra and the urethral termination into the ano rectum. The healthy native urethra was isolated by disconnecting it from its ano rectal termination and a neo urethra constructed from a segment of proximal sigmoid colon by its reconfiguration into a Monti type tube. The neo urethra was then anastomosed to the native urethra and laid within the bed of the De Castro flap so as to reach the neo phallic termination. The De Castro flap was then tabularized ...Continue Reading

References

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Jun 17, 2020·Journal of Pediatric Urology·Jujju Jacob KurianRohith Srinivas

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