Constructing neourethra after urethral damage by a prolene mesh sling – stages and 5-year outcomes

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Abstract

The article presents a successful trial of constructing neourethra with the use of a free graft of the mucous tissue of the cheek in a patient with a post-trauma total urethral loss.

About the authors

Mikhail Yu. Korshunov

Academician I.P. Pavlov First St. Petersburg State Medical University; “Andros Clinic” LLC

Author for correspondence.
Email: mkorshunov@mail.ru

Doctor of Medical Science, Associated Professor, Department of Obstetrics, Gynecology and Reproductology; Consultant Gynecologist 

Russian Federation, Saint Petersburg

Alexey V. Zhivov

“Ilyinskaya Hospital” JSC; “Andros Clinic” LLC

Email: urorec@gmail.com

Candidate of Medical Science, Urologist, Physician in Chief; Consultant Urologist 

Russian Federation, Moscow; Saint Petersburg

Alexey Yu. Plekhanov

“Andros Clinic” LLC

Email: plekhanov3@mail.ru

Candidate of Medical Science, Urologist, Head of Urology Department

Russian Federation, Saint Petersburg

References

  1. Гвоздев М.Ю. Синтетические материалы в урогинекологии // Журнал акушерства и женских болезней. – 2013. – № 2. – С. 43–50. [Gvozdev MYu. The use of synthetic materials in urogynecology. Journal of Obstetrics and Women’s Diseases. 2013;62(2):43-50. (In Russ.)]
  2. Rehman H, Bezerra CA, Bruschini H, et al. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database of Systematic Reviews. 2017;(7): CD001754. https://doi.org/10.1002/14651858.CD001754.
  3. Пушкарь Д.Ю., Касян Г.Р. Ошибки и осложнения в урогинекологии. – М.: ГЭОТАР-Медиа, 2017. – 384 с. [Pushkar DYu, Kasyan GR. Oshibki i oslozhneniya v uroginekologii. Moscow: GEOTAR-Media; 2017. 384 p. (In Russ.)]
  4. Shah K, Nikolavsky D, Gilsdorf D, et al. Surgical management of lower urinary mesh perforation after mid-urethral polypropylene mesh sling: mesh excision, urinary tract reconstruction and concomitant pubovaginal sling with autologous rectus fascia. Int Urogynecol J. 2013;24(12):2111-2117. https://doi.org/10.1007/s00192-013-2146-3.
  5. Коршунов М.Ю., Сазыкина Е.И. Опросник ПД-КЖ — валидированный способ оценки симптомов дисфункций тазового дна и качества жизни у пациенток с пролапсом тазовых органов // Журнал акушерства и женских болезней. – 2008. – Т. 57. – № 3. – С. 86–93. [Korshunov MYu, Sazykina EI. PD-QL Questionnaire – Validated Instrument for Symptoms and Quality of Life Assessment in Patients with Pelvic Organ Prolapse. Journal of Obstetrics and Women’s Diseases. 2008;57(3): 86-93. (In Russ.)]

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Martius Graft (arrow) is obtained from the left labia majora

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3. Fig. 2. Vulva with buccal graft attached to the area of the neourethra (arrow)

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4. Fig. 3. Mucosal tissue engraftment. The brim of the transplant is indicated with an arrow

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5. Fig. 4. The edges of buccal graft are connected (arrow), forming the neourethra

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6. Fig. 5. Wholeness of vulvar epithelium (arrow) over the neourethra is restored

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7. Fig. 6. Fascial sling is placed below bladder neck (arrow)

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Copyright (c) 2020 Korshunov M.Y., Zhivov A.V., Plekhanov A.Y.

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