V3-14: MEGALOURETHRA ASSOCIATED TO BLIND ENDING BULBAR URETHRA AND URETHRO-RECTAL FISTULA: THE CASE FOR ASTRA APPROACH WITH URETHRO-URETHRAL ANASTOMOSIS AND PENILE TAILORING URETHROPLASTY IN ONE SETTING.
VideoIntroductions and Objectives
Megalourethra is a rare spectrum of urologic malformations of penile corporal structures frequently associated with multiple congenital anomalies, such as prune belly syndrome and VACTERL defects. We aimed to present the case of a patient born with a urethro-rectal fistula and megalourethra treated in one setting.
Patient presented at the age of 3 months with history of esophageal atresia surgery and abnormal genitalia characterized by saccular dilated urethra and voiding by an urethral meatus in the anal canal. A cistoscopy showed a blind ending bulbar urethra, confirmed by retrograde urethrogram. Patient was placed in the ventral decubitus and an ASTRA approach was performed to isolate the urethra from the rectum. The penile and bulbar urethra was assessed and an end-to-end urethral anastomosis was performed. We tailored the redundant urethra to treat the dilatation and muscular and subcutaneous tissue overlapped the urethra it to give support, since the patient had no corporal bodies.
Patient had an uneventful postoperative course and voids through the urethra
Megalourethra is a rare and complex disease and can be treated in one setting even in case of associated urethro-rectal fistula