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• W2079019662 abstract "No AccessJournal of UrologyTestes/Intersex1 Sep 1998ANTERIOR SAGITTAL TRANSANORECTAL APPROACH TO THE POSTERIOR URETHRA IN THE PEDIATRIC AGE GROUP FABIO ROSSI, ROBERTO De CASTRO, PIER LUCA CECCARELLI, and REMIGIO DOMINI FABIO ROSSIFABIO ROSSI More articles by this author , ROBERTO De CASTROROBERTO De CASTRO More articles by this author , PIER LUCA CECCARELLIPIER LUCA CECCARELLI More articles by this author , and REMIGIO DOMINIREMIGIO DOMINI More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62730-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Surgical access to the posterior urethra is often difficult and several surgical solutions have been proposed. We suggest an anterior sagittal transanorectal approach based on splitting the anterior rectal wall only. This alternative technique provides excellent exposure to the retrourethral region, permitting simple and safe surgery. Materials and Methods: Between 1994 and 1996 we performed surgery via the anterior sagittal transanorectal approach in 8 patients with a mean age of 9.06 years. Patients included 1 girl with a posttraumatic urethrovaginal fistula, 3 with intersex disorders (2 with mixed gonadal dysgenesis raised as boys and 1 with male dysgenetic pseudohermaphroditism with an enlarged urtricle) and 4 boys (1 with penile agenesis raised as girl, 2 with urethral duplication and 1 with prostatic rhabdomyosarcoma). The patient was placed in a knee-chest position. A midline sagittal incision was made through the anterior anorectal wall only and deepened through the perineal body to expose the posterior urethra and retrovesical space. After the pathological condition was corrected the anterior rectal wall and perineal body were reconstructed. The operation was completed with protective colostomy. In our final patient with prostatic rhabdomyosarcoma the anterior sagittal transanorectal approach was used without colostomy. Anorectal manometry was done 6 months postoperatively. Results: All patients were completely continent of stool and urine. Convalescence was unremarkable in all cases. Postoperative manometry in 7 patients revealed no differences from preoperative measurements. Conclusions: This procedure should be considered a useful alternative to other techniques for various congenital and acquired pelvic disorders. References 1 : Surgical approaches to the prostate. In: . Lausanne, Switzerland: Modern Technics in Surgery1972: 1-11260. Google Scholar 2 : Posterior sagittal anorectoplasty: important technical considerations and new applications. J. Ped. Surg.1982; 17: 796. Google Scholar 3 : The posterior sagittal approach: further pediatric applications. Ped. Surg. Int.1992; 7: 274. 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Link, Google Scholar From the Division of Pediatric Surgery, Department of Pediatrics, University of Bologna, Bologna, Italy© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAlam S, Levitt M, Sheldon C and Peña A (2007) The Posterior Sagittal Approach for Recurrent Genitourinary PathologyJournal of Urology, VOL. 178, NO. 4S, (1668-1671), Online publication date: 1-Oct-2007.BOCCIARDI A, LESMA A, MONTORSI F and RIGATTI P (2018) PASSERINI-GLAZEL FEMINIZING GENITOPLASTY: A LONG-TERM FOLLOWUP STUDYJournal of Urology, VOL. 174, NO. 1, (284-288), Online publication date: 1-Jul-2005.LIMA M, AQUINO A, DÒMINI M, RUGGERI G, LIBRI M, CIMADOR M and PELUSI G (2018) Laparoscopic Removal of Müllerian Duct Remnants in BoysJournal of Urology, VOL. 171, NO. 1, (364-368), Online publication date: 1-Jan-2004.MAUERMANN J, GONZÁLEZ R, FRANC-GUIMOND J and FILIPAS D (2018) THE ANTERIOR SAGITTAL TRANSRECTAL APPROACH FOR TRAUMATIC URETHROVAGINAL FISTULA CLOSUREJournal of Urology, VOL. 171, NO. 4, (1650-1651), Online publication date: 1-Apr-2004. Volume 160Issue 3 Part 2September 1998Page: 1173-1177 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information FABIO ROSSI More articles by this author ROBERTO De CASTRO More articles by this author PIER LUCA CECCARELLI More articles by this author REMIGIO DOMINI More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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