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INTRODUCTION AND OBJECTIVE:There is a paucity of evidence documenting the lived experience of patients with adult acquired buried penis (AABP) and how this condition is affected by surgical treatme...

INTRODUCTION AND OBJECTIVE:The LSE anterior urethral stricture classification system has previously been validated for its interrater reliability and ability to predict urethroplasty technique. Her...

INTRODUCTION AND OBJECTIVE:A successful urethroplasty has been defined in many ways. This variability poses a challenge when trying to compare success rates and techniques across studies. We aim to...

INTRODUCTION AND OBJECTIVE:Lack of genital skin presents a barrier to lining a vaginal canal and creating an aesthetic vulva during gender affirming vaginoplasty. The outcomes for patients with pen...

INTRODUCTION AND OBJECTIVE:Silber and Kelly first described the successful autotransplantation of an intra-abdominal testis in 1976. Over subsequent decades, other authors have adopted the use of l...

INTRODUCTION AND OBJECTIVE:Management of patients with recurrent ureteropelvic junction obstruction (UPJO) after prior failed pyeloplasty is challenging. We demonstrate three robotic non transectin...

INTRODUCTION AND OBJECTIVE:Minimally invasive inguinal lymph node dissection has many benefits as compared to open dissection. While the single port robot has the advantage of one incision, there a...

INTRODUCTION AND OBJECTIVE:Robotic ureteroneocystostomy can be performed via nontransecting side-to-side anastomosis, which eschews ureteral transection to preserve distal vascularity. We have prev...

INTRODUCTION AND OBJECTIVE:Prior work has established that post-operative urethroscopy may be an effective tool to predict re-operation within 1 year following urethroplasty. Here, we examine early...

PurposeWe report multi-institutional outcomes in patients who underwent urethroplasty with a rectal mucosa graft.Materials and methodsWe used the TURNS (Trauma and Urologic Reconstructive Network of Surgeons) database to identify patients who underwent urethral reconstruction with transanal harvest of a rectal mucosa graft. We reviewed preoperative demographics, stricture etiology, previous management and patient outcomes.ResultsWe identified 13 patients from April 2013 to June 2017. Median age at surgery was 54 years. The stricture etiology was lichen sclerosus in 6 of 13 patients (46%), idiopathic in 2 (15%), hypospadias in 1 (7%), prior gender confirming surgery in 3 (23%) and rectourethral fistula after radiation for prostate cancer in 1 (7%). Prior procedures included failed urethroplasty with a buccal mucosa graft in 9 of 13 patients (69%), direct vision internal urethrotomy in 2 (15%) and none in 2 (15%). Median stricture length was 13 cm. Stricture location in the 9 cisgender patients was panurethral in 5 (56%), bulbopendulous in 2 (22%) and bulbar in 2 (22%). It was located at the junction of the fixed urethra extending into the neophallus in all 3 patients (100%) who underwent prior gender confirming surgery. Mean rectal mucosa graft length for urethroplasty was 10.6 cm (range 3 to 16). Repair types included dorsal or ventral onlay, or 2-stage repair. Stricture recurred at a median followup of 13.5 months in 2 of 13 patients (15%). Postoperative complications included glans dehiscence, urethrocutaneous fistula and compartment syndrome in 1 patient each (7%). No rectal or bowel related complications were reported.ConclusionsUrethral reconstruction with a transanal harvested rectal mucosa graft is a safe technique when a buccal mucosa graft is unavailable or not indicated.

Purpose:Penile inversion vaginoplasty is the most common procedure for genital reconstruction in transwomen. While penile inversion vaginoplasty usually provides an excellent aesthetic result, the ...

INTRODUCTION AND OBJECTIVE:Robotic-assisted posterior urethral reconstruction has shown great promise in early series with excellent patency rates. While Y-V or T plasty remains useful for short su...

INTRODUCTION AND OBJECTIVE:The rectus abdominis muscle is a useful flap for multiple surgical repairs including complex posterior urethral fistula repair. Traditional open harvest with anterior she...

INTRODUCTION AND OBJECTIVES:Penile inversion vaginoplasty (PIV) is the most common technique for primary feminizing genital reconstruction in transwomen, which requires regular lifelong dilation to...

INTRODUCTION AND OBJECTIVES:Distal ureteral strictures pose a potential risk for renal impairment. The surgical gold standard involves ureteroneocystotomy with transection of the ureter. We present the technique of side-to-side anastomosis as a useful treatment option that avoids aggressive distal ureteral dissection and further compromise of blood supply. Additionally, the presence of the native ureteral orifice allows for ureteroscopic access if required.METHODS:In this video, we show our robotic surgical technique for side-to-side anastomosis for distal ureteral stricture performed by three genitourinary reconstructive surgeons from three different institutions. Our technique involves the performance of adequate ureterolysis of the healthy, proximal and non-strictured segment. Extensive dissection of the posterior ureter towards the ureterovesical junction is avoided, preventing vascular compromise. Indocyanine dye can be used to demonstrate vascularity prior to anastomosis. A psoas hitch or bladder mo...

INTRODUCTION AND OBJECTIVES:Endoscopic treatment of urethral stricture disease (USD) continues to be the most common treatment of USD despite its poor success compared to urethroplasty. AUA guideli...