Dr. med. Dirk Manski

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Perineal Approach for Urethral Surgery

Urologic Indications

In urology, a perineal incision is used to approach the bulbar or membranous urethra or prostate (Schreiter and Jordan, 2006).

Patient Positioning

Lithotomy position of the patient. Surgery of the membranous urethra or perineal approach to the prostate requires an extreme lithotomy position. With additional flexion of the lumbar spine, lifting of the buttocks (oblique positioning cushion), and increased hip joint flexion, the perineum can be aligned parallel to the floor. The legs are mounted in special holders. The padding of all the relevant pressure points is of paramount importance.

Surgical Technique of a Perineal Approach

Wound Closure:

Close the bulbospongiosus muscle with a running suture (e.g., vicryl 2-0). Adapt the subcutaneous tissue with interrupted sutures.

Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Schreiter, F. & Jordan, G. (ed.) Reconstructive Urethral Surgery
Springer Medizin Verlag Heidelberg, 2006

  Deutsche Version: Perinealer Zugang zur Harnröhre