Urogenital myiasis - An atypical presentation

The infestation of the human body by maggots has been reported worldwide and occurs most commonly in people of lower socioeconomic status and poor personal hygiene. Urogenital is the rarest site of myiasis presentations. Here we report the case of a 20-year-old, sexually inactive female student who presented with a necrotic growth in the paraurethral region infested with numerous maggots. The lesion involved the urethra and the bladder base. She was treated with debridement and bladder irrigation. The cystoscopy and local examination performed 2 weeks after admission, confirmed the complete healing of the urogenital lesion. Managing this patient's unique challenge was to assess the extent of the involvement and removal of all maggots from the deepest wound portion. The female internal and external urogenital myiasis is a very occasional and under-reported health hazard. Reporting such cases increases the public and physician awareness about the mode of presentation, right diagnosis, and available treatment options.

Cambios urodinámicos y en el punto Aa del sistema POP-Q, posterior a la colocación de cinta mediouretral / Urodynamic changes and at point Aa of POP-Q system, after midurethral sling placement

Resumen OBJETIVO: Determinar los cambios en el punto Aa del sistema POP-Q y en la prueba del Q-tip para hipermovilidad uretral y en los parámetros urodinámicos encontrados antes y 1 año después de la colocación de una cinta mediouretral. MATERIALES Y MÉTODOS: Estudio retrospectivo efectuado en pacientes a quienes se colocó una cinta mediouretral mediante acceso transobturador y retropúbico, por diagnóstico de incontinencia urinaria de esfuerzo, incontinencia urinaria mixta, incontinencia dual o con índice de riesgo de incontinencia urinaria de novo, posterior a cirugía de prolapso (R-CALC) mayor de 30%. RESULTADOS: Se estudiaron 200 pacientes de 51.59 ± 10.13 años de edad promedio. Conforme al grado de prolapso de órganos pélvicos, el estadio II tuvo una frecuencia de 57.5% (n = 115), el grado III de 21.5% (n = 43). En los hallazgos de la exploración física, previa a la cirugía, se encontró que 69% (n = 138) de las pacientes tuvieron una prueba de Q tip con hipermovilidad uretral (más de 30°). Al comparar el porcentaje de pacientes con hipermovilidad uretral posterior a 1 año de la cirugía, se observó disminución en las pacientes con hipermovilidad (p = 0.0001). La cuantificación del punto Aa en la escala del sistema POP-Q se encontró durante la exploración preoperatoria a 0.1 ± 1.17 cm respecto del himen y al año del procedimiento quirúrgico a -1.54 ± 1.18 cm, con p = 0.0001. CONCLUSIÓN: En todas las pacientes se demostró la disminución significativa del punto Aa en la revaloración del POP-Q de un estadio II a I posterior a la colocación de una cinta mediouretral; además de la disminución en el ángulo de movilidad uretral. No se observaron modificaciones significativas en los parámetros urodinámicos evaluados.

Abstract OBJECTIVE: To determine the changes in point Aa of the POP-Q system and in the Q-tip test for urethral hypermobility as well as in the urodynamic parameters found before and 1 year after mediurethral sling placement. MATERIALS AND METHODS: Retrospective study carried out in patients who were placed with a mediourethral tape by transobturator and retropubic access, by diagnosis of stress urinary incontinence, mixed urinary incontinence, dual incontinence or with risk index of de novo urinary incontinence after surgery. Prolapse (R-CALC) greater than 30%. RESULTS: 200 patients of 51.59 ± 10.13 years of average age were studied. According to the degree of pelvic organ prolapse, stage II had a frequency of 57.5% (n = 115), grade III with 21.5% (n = 43). In the physical examination findings, prior to surgery, it was found that 69% (n = 138) of the patients had a Q tip test with urethral hypermobility (more than 30°). When comparing the percentage of patients with urethral hypermobility after 1 year of surgery, a decrease was observed in patients with hypermobility (p = 0.0001). The quantification of point Aa on the scale of the POP-Q system was found during the preoperative examination at 0.1 ± 1.17 cm with respect to the hymen and one year after the surgical procedure at -1.54 ± 1.18 cm, with p = 0.0001. CONCLUSION: The significant decrease in point Aa in the reassessment of POP-Q from stage II to I after the placement of a mediourethral tape in all patients was demonstrated, in addition to the decrease in the angle of urethral mobility. No significant changes were observed in the urodynamic parameters evaluated.

Research progress of bladder urethral dysfunction associated with pelvic floor injury in women / 中国医师杂志

Female pelvic floor dysfunction is caused by pelvic floor dysfunction due to pelvic,pelvic organs and lumbosacral tissue lessions,deformities,tumors,trauma,surgery,pregnancy and dystocia.It is called bladder-urethral dysfunction associated with pelvic floor injury.Early diagnosis and targeted treatment of bladder-urethral dysfunction are the key to prevent upper urinary tract damage and obtain good curative effect.Nervous system and urodynamic monitoring are prerequisites for accurate diagnosis and reasonable treatment.

Diagnosis and treatment of urethral mucosa prolapse in female children / 中华泌尿外科杂志

Objective To review the clinical characteristics of urethral prolapse in female children and summarize our experience of treatment.Methods A retrospective analysis of the clinical characteristics of 102 patients with urethral prolapse from January 2007 to December 2017 was conducted at The Children's Hospital of Zhejiang University School of Medicine.The age of the patients ranged from 8-156 months with an median of 80 months.The presenting symptoms in the 102 girls were:bleeding in 57 patients (55.9％),mass in 31 patients (30.4％),and dysuria/urinary frequency,urgent and pain in 14 patients (13.4％).In all,58 patients were managed conservatively with Sitz baths as their masses were small,39 underwent prolapse reduction under topical anesthesia and Sitz baths because their mass were large,and 5 patients were treated by excision of the prolapsed urethral mucosa with four-quadrant excisional technique because thrombosed urethral prolapse at first visit.Results A total of 89 patients were cured after conservative treatment (87.3％),8 patients were converted to surgical treatment because frequent recurrence with conservative treatment.No urethral stricture,active hemorrhage and recurrent were found in 13 patients after operation.Conclusions The most common clinical manifestations of urethral prolapse are urethral mass and bleeding.Most patients can be cured by conservative treatment.The patients whose symptoms were severe or suffered from frequent recurrence of urethral prolapse should be managed with surgical excision.

Application of dermoscopy image analysis technique in diagnosing urethral condylomata acuminata

Abstract: Background: In this study, cases with suspected urethral condylomata acuminata were examined by dermoscopy, in order to explore an effective method for clinical. Objective: To study the application of dermoscopy image analysis technique in clinical diagnosis of urethral condylomata acuminata. Methods: A total of 220 suspected urethral condylomata acuminata were clinically diagnosed first with the naked eyes, and then by using dermoscopy image analysis technique. Afterwards, a comparative analysis was made for the two diagnostic methods. Results: Among the 220 suspected urethral condylomata acuminata, there was a higher positive rate by dermoscopy examination than visual observation. Study limitations: Dermoscopy examination technique is still restricted by its inapplicability in deep urethral orifice and skin wrinkles, and concordance between different clinicians may also vary. Conclusion: Dermoscopy image analysis technique features a high sensitivity, quick and accurate diagnosis and is non-invasive, and we recommend its use.

Effectiveness of syndromic management for male patients with urethral discharge symptoms in Amazonas, Brazil

Abstract: Background: Urethral discharge syndrome (UDS) is characterized by the presence of purulent or mucopurulent urethral discharge.The main etiological agents of this syndrome are Neisseria gonorrhoeae and Chlamydia trachomatis. Objectives: To evaluate the effectiveness of the syndromic management to resolve symptoms in male urethral discharge syndrome cases in Manaus, Amazonas, Brazil. Methods: Retrospective cohort of male cases of urethral discharge syndrome observed at a clinic for sexually transmitted disease (STD) in 2013. Epidemiological and clinical data, as well as the results of urethral swabs, bacterioscopy, hybrid capture for C.trachomatis, wet-mount examination, and culture for N.gonorrhoeae, were obtained through medical chart reviews. Results: Of the 800 urethral discharge syndrome cases observed at the STD clinic, 785 (98.1%) presented only urethral discharge syndrome, 633 (79.1%) returned for follow-up, 579 (91.5%) were considered clinically cured on the first visit, 41(6.5 %) were considered cured on the second visit, and 13(2.0%) did not reach clinical cure after two appointments. Regarding the etiological diagnosis, 42.7% of the patients presented a microbiological diagnosis of N.gonorrhoeae, 39.3% of non-gonococcal and non-chlamydia urethritis, 10.7% of C.trachomatis and 7.3% of co-infection with chlamydia and gonococcus. The odds of being considered cured in the first visit were greater in those who were unmarried, with greater schooling, and with an etiological diagnosis of gonorrhea. The diagnosis of non-gonococcal urethritis reduced the chance of cure in the first visit. Study limitation: A study conducted at a single center of STD treatment. Conclusion: Syndromic management of male urethral discharge syndrome performed in accordance with the Brazilian Ministry of Health STD guidelines was effective in resolving symptoms in the studied population. More studies with microbiological outcomes are needed to ensure the maintenance of the syndromic management.

Evaluation of the fetal urine sample through vesicocentesis: an approach to diagnostic and therapeutic application / Avaliação da urina fetal por meio da vesicocentese: uma abordagem com aplicação diagnóstica e terapêutica

ABSTRACT We report the case of a fetus with mega-bladder and suspected lower urinary tract obstruction (LUTO). The 20-week pregnancy ultrasound scan showed absence of amniotic fluid (anhydramnios), enlarged bladder, and narrowing of the urethra in the proximal region. At 21 weeks of gestational age, vesicocentesis was performed for relief of obstruction and analysis of biochemical of the fetal urine and karyotyping was carried out, which presented normal result (46,XY). This technique is indicated in cases of severe oligohydramnios or difficulty of placental access and has diagnostic and therapeutic function.

RESUMO Relatamos o caso de um feto com megabexiga e suspeita de obstrução do trato urinário inferior (LUTO). O exame ultrassonográfico realizado com 20 semanas de gestação mostrou líquido amniótico ausente (adramnia), bexiga com aumento de volume e estreitamento na região da uretra proximal. Na 21ª semana de gestação, foi realizada a vesicocentese para alívio e análise bioquímica e cariotípica da urina fetal, que apresentou resultado normal (46,XY). Essa técnica é indicada em casos de grave oligodramnia ou dificuldade de acesso placentário e tem função diagnóstica e terapêutica.

The pelvic floor dysfunction associated lower urinary tract diseases / 中国医师杂志

The pelvic floor dysfunction associated lower urinary tract disease.It is women who often multiple diseases,is closely related to the perineum and urogenital diaphragm tissue of old injury and chronic inflammation caused by pregnancy,childbirth,surgical delivery,injection of pelvic trigger point and interventional treatment for the pelvic floor dysfunction associated lower urinary tract diseases is significance.

Analysis of related factors of de novo stress urinary incontinence after pelvic floor reconstruction for patients with pelvic organ prolapse / 局解手术学杂志

Objective To investigate the related factors of de novo stress urinary incontinence after pelvic floor reconstruction.Methods Retrospectively analyzed the clinical data of 714 patients who acceptted pelvic reconstruction surgery in our hospital from November 30,2005 to November 30,2015.Among the 714 cases,there were 544 cases without preoperative urinary incontinence.The possible related factors of de novo SUI caused by operation were statistically analyzed.Results There were 151 cases of de novo stress urinary incontinence after pelvic floor reconstruction,the incidence was about 30.5%.With a history of diabetes,fetal delivery,pelvic surgery and POP surgery(laparoscopic vaginal apical fixation of sacrum) were the risk factors for de novo stress urinary incontinence after pelvic floor reconstruction,and the OR values were 2.575,5.286,1.671 and 1 respectively.There was no correlation between other general data and POP stage(P<0.05).Conclusion When performing pelvic floor reconstruction surgery for POP patients with high risk factors,it's better to have urinary incontinence surgery simultaneously according to individual circumstances and wishes.

Efficacy of mitomycin C in reducing recurrence of anterior urethral stricture after internal optical urethrotomy

PURPOSE: To determine the efficacy of mitomycin C in reducing the recurrence of anterior urethral stricture after internal optical urethrotomy (IOU). MATERIALS AND METHODS: This was a randomized controlled trial conducted in the Department of Urology at the Institute of Kidney Diseases Peshawar from March 2011 to December 2013. A total of 151 patients who completed the study were divided into two groups by the lottery method. Group A (cases) comprised 78 patients in whom mitomycin C 0.1% was injected submucosally in the stricture after conventional IOU. Group B (controls) comprised 73 patients in whom IOU only was performed. Self-clean intermittent catheterization was not offered in either group. All patients were regularly followed up for 18 months. Recurrence was diagnosed by use of retrograde urethrogram in all patients and flexible urethroscopy in selected cases. Data were collected on a structured pro forma sheet and were analyzed by SPSS. RESULTS: The mean age of the patients in group A was 37.31+/-10.1 years and that in group B was 40.1+/-11.4 years. Recurrence of urethral stricture was recorded in 11 patients (14.1%) in group A and in 27 patients (36.9%) in group B (p=0.002). The mitomycin group also showed a delay in recurrence compared with the control group (p=0.002). CONCLUSIONS: Recurrence of urethral stricture is high after optical urethrotomy. Mitomycin C was found to be highly effective in preventing the recurrence of urethral stricture after IOU.

Application of transperineal ultrasound in female urethras and pathological change of circum-urethras / 中华超声影像学杂志

Objective To investigate the application value of transperineal ultrasound in female urethras and pathological change of circum-urethras.Methods 403 female patients were examined by transperineal ultrasound in condition of resting and maximum Valsalva,female urethras and pathological changes of circum-urethras were observed and ultrasonic manifestation were concluded.Results By transperineal ultrasound the images of normal urethras and pathological change of circum-urethras were clearly discernible.403 female patients were examined,380 normal.18 urethral calcification,there was hyperecho stripe in urethras.2 urethral cyst,there was round anechoic area in circum-urethras and no fistula between round anechoic area with urethras.2 urethral diverticulum,there was round anechoic area in circumurethras and a fistula between round anechoic area with urethras.1 urethrovaginal fistula,there was irregular hypoechoic area between urethras with vagina,the irregular hypoechoic area both communicate with urethras and vagina.Conclusions Transperinealr ultrasound can be used for examination urethras and pathological change of circum-urethras in female patients and may provide more reliable information for clinical diagnosis.

Endoscopic urethral realignment aided by urethral probe from suprapubic puncture cystostomy for treating bulbous urethral complete rupture / 重庆医学

Objective To explore the auxiliary method of urethral reunion operation on bulbous urethral complete rupture by en-doscope .Methods 11 cases of bulbous urethral complete rupture were inserted urethral probe from suprapubic puncture cystosto-my ,when it was difficult to find near end of disrupt urethra only by endoscopic realignment .Results 9 cases were reconstructed in one-stage endoscopic urethral realignment with the aid of urethral probe from suprapubic puncture cystostomy .Conclusion Ure-thral probe from suprapubic puncture cystostomy will improve the success rate of one-stage endoscopic urethral realignment for the cases of bulbous urethral complete rupture .

Is a sequence of tests during urethral pressure profilometry correlated with symptoms assessment in women?

Our purpose was, applying a strictly defined protocol for urethral profilometry, 1) to test the repeatability of same session rest maximum urethral closure pressure (MUCP) and 2) to search for correlation between women complaint and the changes in MUCP value (rest and dynamic tests).

A population of 140 consecutive women referred for evaluation of lower urinary tract dysfunction was stratified in 4 groups according with the urinary symptoms: stress, urge, mixed incontinence and continent and in each group in 3 age groups (young, middle age and old). The sequence of tests recorded in supine position was: urethral pressure profile at rest bladder empty, after bladder filling at 250 mL (reference test), stress profile, fatigability (before (rest) and after 10 successive strong coughs), then in standing position.

In all groups, there was no significant difference between the two MUCP values at rest bladder filled. In the three incontinent groups, MUCP was higher bladder empty than bladder filled (p < 0.05) except in the young sub-group. Stress incontinence led to significant decrease of MUCP during dynamic tests in the young group. MUCP was not modified after fatigability test in women with urge complaint whatever age.

When recorded following a strictly defined protocol, MUCP at rest bladder filled has a good repeatability in individual. However a complex sequence of tests during urethral pressure profilometry remains discussed in middle-age and old age-groups, it allows specifying the stress component of incontinence in young women and the urgency component in all age-groups. .

Uropatias obstrutivas bilaterais fetais: sinais ultrassonográficos durante a gravidez e evolução pós-natal / Fetal bilateral obstructive uropathies: ultrasound findings during pregnancy and postnatal outcomes

OBJETIVO: verificar a associação entre sinais ultrassonográficos durante a gestação e evoluções pós-natais em casos de fetos com uropatias obstrutivas bilaterais, acompanhados de forma expectante. MÉTODOS: fetos com uropatias obstrutivas bilaterais apresentando oligoâmnio grave e tórax estreito foram comparados a fetos com uropatias obstrutivas bilaterais que não desenvolveram estas alterações com relação à presença ou ausência de cistos em ambos os rins e à presença ou ausência de hiperecogenicidade de parênquima em ambos os rins. Casos em que houve óbito do neonato foram comparados com aqueles em que o neonato teve alta do berçário em relação aos mesmos aspectos ecográficos renais acima citados, à presença de oligoâmnio grave e de tórax estreito. A sensibilidade, a especificidade, os valores preditivos positivo e negativo da presença de cistos renais bilaterais, hiperecogenicidade renal bilateral, oligoâmnio grave e tórax fetal estreito para óbito do neonato foram calculados. RESULTADOS: o oligoâmnio grave e o tórax estreito foram mais frequentes (p=0,03; p<0,001) nos fetos que tiveram cistos renais bilaterais quando comparados àqueles com parênquimas renais ecograficamente normais. O óbito neonatal foi mais frequente entre os casos que tiveram oligoâmnio grave (p<0,001), tórax estreito (p<0,001) e cistos renais bilaterais (p<0,002) quando respectivamente comparados aos casos sem essas alterações. Os melhores valores de sensibilidade, especificidade, valores preditivos positivo e negativo para óbito do neonato/lactente foram obtidos com o uso do aspecto ecográfico tórax estreito, tendo sido de 81,8, 100, 100 e 79,3 por cento, respectivamente. CONCLUSÕES: Em casos de fetos com uropatias obstrutivas bilaterais acompanhados de forma expectante, os sinais ultrassonográficos mais associados ao mau prognóstico são o oligoâmnio grave, o tórax fetal estreito e a presença de cistos renais bilaterais.

PURPOSE: to verify the association between ultrasonographic signs during gestation and post-delivery evolution in fetuses with bilateral obstructive uropathies, followed up in an expectant way. METHODS: fetuses with bilateral obstructive uropathies presenting severe oligoamnios and narrow thorax have been compared with fetuses with bilateral obstructive uropathies without those alterations, concerning the presence or absence of cysts in both kidneys, and the presence or absence of parenchymal hyperechogenicity in both kidneys. Cases of neonatal death were compared with cases of neonatal discharge from the nursery, regarding the same renal echographic aspects mentioned above, the presence of severe oligoamnios and narrow thorax. The sensitivity, specificity, positive and negative predictive value of the presence of bilateral renal cysts, bilateral renal hyperechogenicity, severe oligoamnios and narrow fetal thorax for the neonatal death were calculated. RESULTS: severe oligoamnios and narrow thorax were more frequent (p=0.03; p<0.001) in fetuses with bilateral renal cysts, as compared to those with echographically normal renal parenchyma. Neonatal death was more frequent among cases with severe oligoamnios (p<0.001), narrow thorax (p<0.001) and bilateral renal cysts (p<0.002), when respectively compared with cases without those alterations. The best values of sensitivity, specificity, positive and negative predictive value for the death of neonatal/breastfeeding infants were obtained using the echographic aspect of narrow thorax, and were 81.8, 100, 100 and 79.3 percent, respectively. CONCLUSIONS: in cases of fetuses with bilateral obstructive uropathies followed up in an expectant way, the ultrasonographic signs more associated to bad prognosis are severe oligoamnios, narrow fetal thorax and presence of bilateral renal cysts.

Female urethral diverticulum associated witha large urinary calculus / Divertículo de uretra feminina associado a grande cálculo urinário

The diverticula of female urethra are very uncommon, but more frequently found between the third and fifth decade of life. Diverticula area mostly relate to repeated urinary infections of the periurethral glands or urethras trauma. The diverticula may cause infection, calculus formation and rarely endometriosis or cancer. A case of a 65-year old Caucasian female with vaginal mass over six months is herein reported. There was no urinary loss, urethral secretion or urinary symptoms. A cystourethrography showed diverticula with calculus inside. The patient was submitted to surgery and dismissed from the hospital on the first postoperative day. The pathologic examination revealed no malignancy. In six months of follow-up, the patient was continent with no complaints.

Os divertículos de uretra feminina são incomuns, porém mais frequentes entre a terceira e a quinta década de vida. A maioria dos divertículos de uretra está relacionada a infecções recorrentes das glândulas periuretrais ou traumatismo uretral. Os divertículos podem ser sítio de infecções, formação de cálculos e, mais raramente, endometriose ou neoplasia. Relata-se o caso de paciente de 65 anos, branca, com queixa de nódulo em parede vaginal notado há seis meses. Negava incontinência urinária, derrame uretral e sintomas urinários de armazenamento ou de esvaziamento. A uretrocistografia miccional revelou divertículo uretral associado a cálculo. Submetida à cirurgia, teve alta hospitalar no primeiro dia pós-operatório. O resultado do exame anatomopatológico não evidenciou malignidade. Após seis meses de seguimento, a paciente encontra-se sem queixas urinárias ou vaginais e com continência urinária preservada.

Various Types of Urethral Duplication Found in Boys / 대한비뇨기과학회지

Urethral duplication is a rare congenital anomaly that can present in various clinical forms according to the plane and extent of duplication. Although some are associated with abnormalities of the external genitalia, others present as mild condition which is incidentally found. Nine cases of complete and incomplete types of urethral duplication have been reported in the Korean literature. We report the clinical presentation and management of four cases of various types of urethral duplication in boys

Urodynamic evaluation for women with lower urinary tract symptoms / 中国基层医药

Objective To evaluate the video urodynamic abnormalities of women with lower urinary tract symptoms.Methods 38 females with lower urinary tract symptoms underwent video urodynamic test.Filling cystometry was done with 15% urographin saline fluid.A diagnosis was made in each case based on cystometrography finding,voiding pressure flow study,EMG and fluoroscopic appearance.Results Video urodynamic showed abnormalities in 23 cases(60.5%),including sensory urgency in 6,detrusor instability(DI) in 5,pseudodyssynergia(PDS) in 4,PDS+DI in 2,urethral orifice stricture in 2,DI+urgency incontinence in 1,impaired compliance in 1,bladder neck stricture in 1 and urethral diverticulum in 1.Conclusion Video urodynamic is useful not only for understanding the abnormalities of functions and morphology of women with lower urinary tract symptoms,but also for properly diagnosing and treating such cases.

Prevalence of lower urinary tract symptoms in young and adolescent females in Luoyang City / 中华全科医师杂志

0.05).Overall prevalence of UI was 15.93% in the students,20.45% in those of junior high school,10.44% in senior high school and 16.72% in university(P0.05),accounting for 63.90%,10.47% and 25.63% of the total students with UI.Conclusions Great importance should be attached to the higher prevalence of LUTS in young and adolescent females by gynecologists and urologists.More attention should also be paid to health education on LUTS and medical care for those with LUTS to alleviate and delay occurrence of UI symptoms.

Curative Effect of Special Acupuncture Techniques on Female Urethral Syndrome and its Relationship with the Course of Treatment / 针灸推拿医学（英文版）

Purpose To observe the curative effect of special acupuncture techniques on female urethral syndrome and its relationship with the course of treatment.Method Four abdominal and four sacral empirical points were acupunctured with special techniques and electricity. A difference in curative effect was investigated between different numbers of treatments. Results The clinical cure rate reached 15.2% just after ≤ 10 (7.3 ± 1.3) treatments. The curative effect was significantly better after 20-40 (32.1 ± 5.8) treatments than after ≤ 10 (7.3± 1.3) treatments (χ2 = 10.086, P ＜0.05). The clinical cure rate reached 43.5% in the former. Conclusion Special acupuncture techniques have a good clinical effect on female urethral syndrome. The curative effect improves with an increase in the number of treatments.

Primary urethroplasty with the use of two pedunculated flaps of lip of pudenda for female urethral oblite ration (report of 2 cases) / 中华泌尿外科杂志

Objective To improve the urethroplasty efficacy for female urethral obliteration by the use of 2 pedunculated flaps of the lip of pudenda. Methods 2 cases of female urethral obliteration were treated with the use of 2 pedunculated flaps of lip of pudenda to repair the urethral obliteration. Results Both the patients could pass urine freely and needed no dilation of the urethra during the 15 and 36 months of follow up.The maximum flow rate were 18.2 ml/s、17.7 ml/s,the average flow rate were 9.0 ml/s、 10.9 ml/s and the voiding volume were 206 ml、247 ml. Conclusions Urethroplasty with the use of pedunculated flaps of lip of pudenda is a safe and effective procedure.