However tension-free anastomosis is necessary for achieving high success rates, bulbar urethral mobilization8 using the perineal approach was simultaneously performed. Bulbar urethral mobilization was used in distal to midshaft hypospadias surgery.9 There seem to be few reports on the treatment OSI-906 purchase of anterior urethral stricture with bulbar urethral mobilization in pediatric patients. In this procedure, a short midline
perineal incision was made, and the bulbospongiosus muscle was reflected. The entire length of the anterior urethra was mobilized, and the bulbar urethra was advanced anteriorly. The primary blood supply to the bulbar urethra was antegrade flow from the posterolateral bulbar vessels, and the secondary blood supply was retrograde vascularization from the glans.8 In hypospadias cases, however, there is no retrograde blood supply from the glans because of circumferential atresia of the distal
spongiosus. Thus, particular attention should be paid while dissecting and mobilizing the bulbar urethra to prevent injury to the antegrade blood supply from the posterolateral bulbar vessels. However, in our case, there was no history of hypospadias or penile reconstruction surgery, Fulvestrant in vivo and special care was not required to prevent injury to the blood supply from either antegrade flow from the posterolateral bulbar vessels or retrograde flow from the glans. Tension-free end-to-end anastomosis could be performed, and the postoperative course has been uneventful. We described our experience with anterior urethroplasty with bulbar urethral mobilization performed for the treatment of intractable recurrent anterior urethral stricture for which treatment with EIU and urethral dilatations
was repeatedly to unsuccessfully. We believe it is possible to perform single-stage urethroplasty with end-to-end anastomosis without tension using bulbar urethral mobilization even in patients with comparatively long anterior urethral strictures. None of the authors have any potential conflicts of interest to declare. “
“Spontaneous bladder perforation (SBP) is an extremely rare event with almost all of the cases reported having a history of previous bladder manipulation, lower urinary tract obstruction, pelvic radiotherapy or surgery, inflammation, and malignancy.1 Other lesser causes reported include binge alcohol intake and tuberculosis cystitis.2 Because of its rarity, SBP is often very low or is never on the differential leading to a very high mortality rate. We report a case of a 36-year-old man with no known significant medical or surgical history who awoke in the early morning hours with abdominal pain, nausea, vomiting, and hematuria.
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