SURGICAL REPAIR OF URETHRAL STRICTURE Posterior Urethroplasty by the Michalowski Method

• Published in: Nippon Hinyokika Gakkai zasshi Vol. 79; no. 3; pp. 475 - 480
• Main Authors: Inoue, Takeo, Osada, Takao, Kuroko, Kohichi, Hamao, Takumi, Ohyama, Noboru, Hirano, Akihiko
• Format: Journal Article
• Language: Japanese
• Published: Japan THE JAPANESE UROLOGICAL ASSOCIATION 01.03.1988
• Subjects: Adolescent; Adult; Child, Preschool; Humans; Male; Methods; Middle Aged; Urethra - surgery; Urethral Stricture - surgery
• ISSN: 0021-5287; 1884-7110
• DOI: 10.5980/jpnjurol1928.79.3_475

During the past 21 years, we have repaired 36 cases of posterior urethral stricuture following traumatic pelvic fracture. The Michalowski method was applied to 6 cases with follow up observation period of 1 to 21 years (average 8.8 years). As for complications, 2 cases of impotency and 3 cases of ejaculatory disturbance were noted. However, neither restenosis nor urinary incontinence occurred and postoperative voiding status was satisfactory in every case. Posterior urethral defect more than 5cm long, stenosis extending from the membranous to the bulbous urethra and immobilished anterior urethra are the indications of this Michalowski method. The Key points of this method are as follows: (1) X-type skin incision is recommended when the operative method is not decided before surgery. (2) 26F Foley catheter for adults and 22F for children are indwelt in the perineal fistula. (3) Distal urethral anastomosis should be done cautiously with less reactive suture material. (4) The skin tube as anterior urethra ahould be burned deep enough and straight. A representative case with 7cm urethral defect treated successfully by this Michalowski method is reported.