V06-05 "GIL-VERNET" SCROTAL-PERINEOSTOMY: SURGICAL TECHNIQUE

Abstract

You have accessJournal of UrologyLower-Tract Reconstruction I: Sling/ Sphincter/ Penile & Urethral Reconstruction (V06)1 Apr 2020V06-05 "GIL-VERNET" SCROTAL-PERINEOSTOMY: SURGICAL TECHNIQUE Alfredo Gil-Vernet*, Manuel CÉspedes, Jordi Ropero, and Franklin DÍaz Alfredo Gil-Vernet*Alfredo Gil-Vernet* More articles by this author , Manuel CÉspedesManuel CÉspedes More articles by this author , Jordi Ropero Jordi Ropero More articles by this author , and Franklin DÍazFranklin DÍaz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000885.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 1967, at the XIV Congress of the Société Internationale d'Urologie, Prof. JM Gil-Vernet first described a two-stage urethroplasty for post-traumatic urethral strictures using an inverted "U-shaped" flap of scrotal skin with a broad perineal base (Traitement des Sténoses Post-Traumatiques de l'Urètre, München: 1967, vol. 2, pp. 271–3). The in-depth anatomical study of scrotal vascularization led us to the subsequent development of the biaxial epilated scrotal flap (“BAES-flap”) that we have applied for the reconstruction of complex urethral strictures. In patients with multioperated anterior stricture, panurethral disease secondary to lichen sclerosus, and especially in those advanced age patients with comorbidities, performing a definitive perineal urethrostomy can be considered a technique of choice. Unlike the taut perineal skin, the elasticity, length and availability of the scrotal "BAES-flap”, allows a wide anastomosis to the edges of the posterior urethra without tension. METHODS: The video describes step by step our surgical technique for the creation of a definitive perineo-scrotal urethrostomy in a patient with a panurethral stricture disease. A similar maneuver to facilitate the placement of stitches in the deep posterior urethra like those described previously by John Blandy in 1986 and by George Webster in 1993, is depicted in detail. RESULTS: The scrotal “BAES-flap” allows a tension-free perineal urethrostomy to be performed and at the same time places the new meatus away from the perianal area, which also contributes to improving patient's hygiene and quality of life. CONCLUSIONS: The characteristics and versatility of the scrotal "BAES-flap” facilitate the realization of a perineal urinary diversion in the most complex cases. Source of Funding: None. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e557-e557 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alfredo Gil-Vernet* More articles by this author Manuel CÉspedes More articles by this author Jordi Ropero More articles by this author Franklin DÍaz More articles by this author Expand All Advertisement PDF downloadLoading ...