Rupture of the bulb of the urethra: repair effectuated using a patch of human dura mater

Patch grafting the renal pelvis and ureteropelvic junction. A comparative study in pigs using lyophilized dura mater and free peritoneum

Lyophilized dura mater (Lyodura) and autogenous free peritoneum were compared in the replacement of the partially resected renal pelvis and uretero-pelvic junction (UPJ) in the pig. The Lyodura and peritoneum grafts were both progressively resorbed, and replaced by fibroblasts which formed a mature scar lined by transitional epithelium, but without smooth muscle regeneration. Lyodura was found to be superior to free peritoneum with a longer time before resorption of the graft, less intense inflammatory reaction, absence of metaplastic bone formation, less risk of urine leak and greater ease of surgical manipulation.

Surgical treatment of male urinary incontinence

Between January 1975 and December 1981 we treated 34 men with urinary incontinence with surgical intercavernous embedding of the bulboperineal urethra along its entire length. The etiology of incontinence was sphincteric damage following either prostatectomy (30 cases) or pelvic trauma (4 cases). All patients had complete neurologic integrity of the detrusor, 25 (75 per cent) had complete urinary continence, 5 (15 per cent) experienced considerable improvement, while 4 were failures. Followup ranged from 7 years to 4 months. Details of the surgical procedure are described, preoperative and postoperative management is emphasized and results are presented.