ESPU Congress 2018 - Abstract Book

201 11–14 APRIL, 2018, HELSINKI, FINLAND VD-8 (VS without presentation) ONE-STAGE Y-TYPE URETHRAL DUPLICATION REPAIR WITH PERINEAL SKIN FLAP Diana K. BOWEN  1 and Arun K. SRINIVASAN  2 1) The Children's Hospital of Philadelphia, Division of Urology, Department of Pediatric Surgery, Philadelphia, USA - 2) The Children's Hospital of Philadelphia, Division of Pediatric Urology, Department of Surgery, Philadelphia, USA PURPOSE Urethral duplication of the Y subtype is a rare anomaly. Many techniques have been described in case reports, most including two-staged repairs for long urethral defects. Our aim is to demonstrate a prone approach with a one-stage substitution urethroplasty using a perineal skin flap. PATIENTS AND METHODS The patient was a 20 month old male who had previously undergone circumcision and correc- tion of scrotal transposition but was subsequently found to have a Y-type duplicated urethra. The dorsal urethra extended to an orthotopic meatus but was narrow and stenotic, while the supple ventral urethra coursed from the posterior urethra to the perineum adjacent to the anal verge in the midline. Given the nature of this fistulous Y-duplication, reconstruction was necessary. Exam under anesthesia revealed an intact rectal sphincter separate from the ventral urethra. After placement of a suprapubic catheter, surgery was approached in the prone position. The ventral urethra was separated from the anterior rectal wall and the midline incision was continued through the perineum anteriorly. A 2 cm x 1.5 cm perineal skin flap attached to the urethra was developed for use in reconstruction. Dissection revealed an atretic 3 cm segment of the dorsal urethra that transitioned to a normal tube within the pendulous urethra. The healthy ventral urethra with skin flap served as the rotated substitution urethra and onlay flap to reconstruct the channel over a 10 Charriere catheter in a tension-free manner. RESULTS The patient did well postoperatively with cystogram and retrograde urethrogram at 4 weeks confirm- ing patency and remained clinically well at 7 month follow up. CONCLUSIONS We describe a one-stage technique for Y subtype urethral duplication in the prone position by rota- tion of the ventral urethra with perineal skin flap to a tension-free anastomosis. As always, long term follow-up is paramount. VD-9 (VS without presentation) RETROPERITONEAL ROBOT-ASSISTED LAPAROSCOPIC REPAIR FOR URETEROPELVIC JUNCTION OBSTRUCTION Thomas BLANC, Pauline CLERMIDI, Henri LOTTMANN, Nathalie BOTTO, Luca PIO and Yves AIGRAIN Hôpital Necker - Enfants Malades, Department of Pediatric Surgery and Urology, Paris, FRANCE PURPOSE Robot-assisted laparoscopic pyeloplasty (RALP) has been gaining acceptance among pediatric urologists. Few studies have evaluated the retroperitoneal approach of RALP. This video demon- strates a pyeloplasty for ureteropelvic junction obstruction with polar vessel.