Novel Plicating "Wrap" Technique for Treating Anterior Urethral Ballooning.

ABSTRACT

OBJECTIVE: To describe an original approach, inspired by the technique proposed by Kalicinsky, which has the advantages of not requiring opening of the urethra, modeling the urethra to a suitable caliber without urethral anastomosis and providing the urethra with a solid and stretchable ventral support. MATERIALS AND METHODS: We operated on 3 cases of anterior urethral ballooning between November 2013 and June 2014. Retrograde and micturition urethrography ruled out any urethral anastomosis and disclosed the ballooning. A 10-F silicone catheter was placed in all 3 cases with the purpose of monitoring the tailoring. Complete dissection of the urethral "sac" was carried out regarding circumference and length, and the result was a normal urethra with respect to both the penoscrotal angle and the glans. Urethral tapering was then undertaken with a continuous 5-0 polyglactin suture, which produced a straight urethra just a little wider than the previously placed monitoring catheter. The remnants of the dilated urethra were wrapped around the urethra with the aid of 2 traction stitches. Urethral tailoring was completed with a longitudinal suture that fixed the wrap. The urethral catheter was left 1 week after. RESULTS: The children urinated without problems and with a good micturition jet that remained unaltered over the ensuing months. CONCLUSION: A novel technique for treating a rather infrequent pathology has been described. The reported technique is simple and reproducible, and our 3 cases had excellent cosmetic and functional results.