[Urethroplasty using a pedicled labial flap in the treatment of urethral destruction of obstetrical origin: technics and results].

OBJECTIVES: To present a new technique for urethral reconstruction, the pedicled labial urethroplasty ULP, and describe the results obtained in patients treated for extensive urethral cervical damage after obstetrical injury.

METHODS: From January 1992 to January 1996, pedicled labial urethroplasty (ULP), was performed on 31 African female patients, with an average age of 18 years old. The ULP was performed by using a pedicled skin flap obtained from the major labia. The pedicled flap is slid beneath the vaginal epithelieum until the damaged urethra is reached. Different techniques are then proposed : partial urethroplasty, by using a patch to lengthen the existing urethra, or complete reconstruction of the urethra by the use of a tubularized flap. Good quality urine continence was obtained by using the sub urethral Martius' sling procedure. In 6 cases, we combined the treatment with a colposuspension procedure. Post operation follow-up were done during a period of 13 months (6 to 32 months).

RESULTS: In 19 out of 27 cases (70%) normal miction was obtained and the urinary leak cured. While 4 results were considered semi-failures, for 4 other cases failure was considered complete.

CONCLUSION: The pedicled labial urethroplasty ULP has shown to be a reliable technique and highly suitable for the management of extensive urethral cervical damage after obstetrical injury.