Endourologic reconstruction of post-traumatic obliterated urethral stricture in a young female: A point of technique

Introduction. A simple endourologic technique for reconstruction of a post-traumatic obliterated urethra in a young unmarried woman is described as an alternative management to complex open urethral reconstruction. Technical Considerations. A 20-year-old woman presented with a post-traumatic obliterated urethra after a road traffic accident. The cystogram at 6 weeks did not reveal a bladder neck or urethra. The examination under anesthesia showed just a dimple at the presumed external urethral meatus. Antegrade cystoscopy revealed a complete block just distal to the bladder neck. A puncture was made from the external urethral meatus into the bladder through the bladder neck under antegrade cystoscopic guidance. The tract was dilated up to 18F using fascial dilators over a guidewire. A 16F Foley catheter was placed for 6 weeks. The operative time was 30 minutes, with no intraoperative complications. The catheter was removed at 6 weeks. Urethroscopy showed a normal urethra. She performed self-catheterization for the initial 3 months. A micturating cystourethrogram at 3 months revealed a normal urethra. She was continent and stricture free at follow-up of 16 months. Conclusion. This technique is simple and easy, with good results in selected cases of post-traumatic complete obliteration of the urethra with an intact bladder neck in young women.