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RECONSTRUCTION OF FEMALE URETHRA BY MEANS OF CLITORIDAL ROOTS
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Muscle fibers, fibrous and elastic canvas and substancia propria of the bladder layers differ considerably from urethral tissues . That is why I started to rebuild lost urethras with clitoridal roots, i.e. corpora cavernosa , whose elasto-vascular structures are much more alike. than a vesical tube. |
Master Plan
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Left and right : making of the graft layer with the distal parts of clitoridal roots. The graft is to be inserted between the inner mucosal plan and the outer vaginal cover plan. Center : shows the insertion line of the three bundles of the ischio-cavernous muscle that are shifted, following local conditions, with cavernous tissues ; reminds that the Martius graft by itself is only a richly vascularized fat padding tissue with no fibrous strength. |
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For precise technical data : see paper published articles in REFERENCES page |
Illustrations
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Incision upon the ischiatic bone |
Freeing of the clitoridal root and muscle fibers |
Shifting the distal part to be drawn through the vaginal wall unto the central line |
Three plans reconstruction
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Operating theater pictures
1, 2, 3, superposing the three plans A 10 or 12 Fr catheter is left in place for about 12 days. It may be passed through a buttonhole in the pubic skin in order to reduce the weight pressure on the new urethra. Draining by suprapubic cystostomy and no urethral catheter at all, and unsticking the small adherences afterwards , could be a better method. |
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