PMC7559505_01
RUG in the left oblique view showing a 7 cm long partial occlusion of the penile and bulbar urethra.
CRIU2020-8822007.001.jpg
PMC7559505_01_CRIU2020-8822007.001.jpg
fig1
Harvesting oral mucosa graft from the lower lip, and a wheal raised with epinephrine solution.
CRIU2020-8822007.002.jpg
PMC7559505_01_CRIU2020-8822007.002.jpg
fig2
A 7 cm x 2 cm lower lip oral mucosa graft starting from the right lateral angle of the mouth extending to the left cheek (Figures 2 and 3) was harvested.
Oral mucosa graft being harvested from the lower lip.
CRIU2020-8822007.003.jpg
PMC7559505_01_CRIU2020-8822007.003.jpg
fig3
A 7 cm x 2 cm lower lip oral mucosa graft starting from the right lateral angle of the mouth extending to the left cheek (Figures 2 and 3) was harvested.
Urethra mobilized completely off the ventral surface of the corporeal bodies and rotated 180  with the aid of distal and proximal sutures (arrows).
CRIU2020-8822007.004.jpg
PMC7559505_01_CRIU2020-8822007.004.jpg
fig4
The urethra was then rotated 180  bringing the dorsal aspect ventrally with the aid of sutures placed proximally and distally on the dorsal aspect of the urethra (Figure 4).
Initial dorsal incision on the catheter tip (arrow) to expose a healthy urethral lumen.
CRIU2020-8822007.005.jpg
PMC7559505_01_CRIU2020-8822007.005.jpg
fig5
A dorsal stricturotomy was made over the strictured segment starting distally from the immediately adjacent patent urethral segment over the catheter tip (Figures 5 and 6).
The narrowed urethral segment has been opened up under direct vision, and the oral mucosa graft has been quilted to the underside of the corporeal bodies.
CRIU2020-8822007.006.jpg
PMC7559505_01_CRIU2020-8822007.006.jpg
fig6
A dorsal stricturotomy was made over the strictured segment starting distally from the immediately adjacent patent urethral segment over the catheter tip (Figures 5 and 6).
Suturing the left edge to the urethral plate to the left lateral aspect of the graft.
CRIU2020-8822007.007.jpg
PMC7559505_01_CRIU2020-8822007.007.jpg
fig7
Suturing the right edge of the graft to the right aspect of the urethral plate over the size 16Fr catheter.
CRIU2020-8822007.008.jpg
PMC7559505_01_CRIU2020-8822007.008.jpg
fig8
Final wound closure with a catheter drain left in situ.
CRIU2020-8822007.009.jpg
PMC7559505_01_CRIU2020-8822007.009.jpg
fig9
Postoperatively, a size of 16Fr catheter wound drain was left in situ and closed wound dressing done (Figure 9).
Healed donor site.
CRIU2020-8822007.010.jpg
PMC7559505_01_CRIU2020-8822007.010.jpg
fig10
RUG in the left oblique view 4 weeks posturethroplasty showing normal caliber anterior urethra with no contrast extravasation.
CRIU2020-8822007.011.jpg
PMC7559505_01_CRIU2020-8822007.011.jpg
fig11
Both the suprapubic and urethral catheters were removed 4 weeks postoperatively when RUG showed no urinary extravasation (Figure 11).