Novel Plicating “Wrap” Technique for Treating Anterior Urethral Ballooning

Abstract

To describe an original approach, inspired by the technique proposed by Kalicinsky, which has the advantages of not requiring opening of the urethra, modeling the urethra to a suitable caliber without urethral anastomosis and providing the urethra with a solid and stretchable ventral support. We operated on 3 cases of anterior urethral ballooning between November 2013 and June 2014. Retrograde and micturition urethrography ruled out any urethral anastomosis and disclosed the ballooning. A 10-F silicone catheter was placed in all 3 cases with the purpose of monitoring the tailoring. Complete dissection of the urethral "sac" was carried out regarding circumference and length, and the result was a normal urethra with respect to both the penoscrotal angle and the glans. Urethral tapering was then undertaken with a continuous 5-0 polyglactin suture, which produced a straight urethra just a little wider than the previously placed monitoring catheter. The remnants of the dilated urethra were wrapped around the urethra with the aid of 2 traction stitches. Urethral tailoring was completed with a longitudinal suture that fixed the wrap. The urethral catheter was left 1 week after. The children urinated without problems and with a good micturition jet that remained unaltered over the ensuing months. A novel technique for treating a rather infrequent pathology has been described. The reported technique is simple and reproducible, and our 3 cases had excellent cosmetic and functional results.