Urethroplasty anastomotic technique

Anastomotic technique for posterior urethroplasty (eg, for pelvic fracture and urethral distraction defect).
(A) After transection of the urethra, the distal portion of the urethra is spatulated dorsally and the proximal urethra is spatulated ventrally. Stitches are placed starting at the 12 o'clock position, and sutures are placed in a clockwise fashion. The inset depicts the push-pull technique for placing the proximal portion of the sutures.
(B) Once tied down, the full-thickness sutures provide a watertight anastomosis with a tension-free reconstruction.