By Steven B. Brandes MD (auth.), Steven B. Brandes, Allen F. Morey (eds.)
Since the booklet of the 1st variation of Urethral Reconstructive Surgery, very important refinements were extra to the urologic surgical armamentarium. widely revised and up-to-date, Advanced Male Urethral and Genital Reconstructive surgical procedure, moment variation guides urologists in a realistic demeanour on the best way to evaluation and deal with advanced urethral and male genital reconstructive demanding situations. Chapters were further on wound therapeutic, synchronous urethral strictures, non-transecting anastomotic urethroplasty (including muscle and vessel sparing), overlapping buccal grafts, male urethral slings, genital dermis grafting, Peyronie’s surgical procedure, priapism, pediatric strictures and prosthetics. Such chapters enormously increase the final charm of the booklet. the amount closes with a brand new complete appendix of most well liked instruments.
With wide contributions by means of overseas professionals in reconstructive urologic surgical procedure, Advanced Male Urethral and Genital Reconstructive surgical procedure, moment Edition is a necessary source for all urologists, from citizens to reconstructive surgeons.
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Extra resources for Advanced Male Urethral and Genital Reconstructive Surgery
For successful anastomotic urethroplasty, an intact and adequate dual urethral arterial blood supply is essential. The key vascular feature of the urethra and the reason that it can be mobilized extensively and divided is its unique bipedal blood supply. The proximal and distal ends of the urethra are supplied by two arterial blood supplies, the proximal urethra in an antegrade fashion and the distal, retrograde. The common penile artery, a branch of the internal pudendal, first branches into the bulbar and circumflex cavernosal arteries (supplying the proximal corpus spongiosum) and then bifurcates into the central cavernosal arteries and into the dorsal artery of the penis.
11). Urethral ischemic necrosis or ischemia refers to recurrence of stricture of the anterior and proximal urethra after excision and primary anastomosis (EPA) urethral surgery. Such ischemic strictures are particularly difficult to manage because often they are very long and have either a very narrow caliber or completely obliterate the proximal anterior urethra. In contrast, technical error strictures are typically short, annular, and easily amenable to internal urethrotomy. Jordan and Colen , upon reviewing all their failed posterior urethroplasties after pelvic fracture, observed that patients who developed the severe complication of proximal urethral necrosis all seemed to have one or more of the same characteristics; namely, previous histories of pelvic fracture associated with vascular injuries were children, were elderly, had a cold or decreased sensate glans penis, had decreased erections, or had failed prior posterior urethroplasty.
F. A. Humphrey Fig. 1 Anatomy of the male urethra (From Carroll and Dixon ) (transitional cell), although prostatic epithelium may also be found. 5 cm in length, is the shortest segment of the male urethra. It is lined by stratified/pseudostratified columnar epithelium and is surrounded by skeletal muscle fibers of the urogenital diaphragm (external urethral sphincter). The bulbous urethra is 3–4 cm in length, has a larger luminal caliber than the prostatic or membranous urethra, and extends in the root of the penis within the bulb of the corpus spongiosum from the distal margin of the urogenital diaphragm to the penile urethra (Fig.