Revision sheet

Male urethrectomy after cystectomy

9 steps, each one the authored title and caption from the interactive animation, with the frame captured from that step. Read it before the case, or print it and work through the steps in order.

Teaching only, not for diagnosis or treatment decisions. The text on this sheet is the animation's own step copy, reproduced verbatim.

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UrOops3D · UroRef · © Nity G

  1. 01

    The retained urethra

    Male urethrectomy after cystectomy. Step 1: The retained urethra. Captured frame from the interactive animation.
    • Cystectomy and a conduit some time ago; now a recurrence in the retained urethra.
    • The pelvis is empty: small bowel lies on the pelvic floor and the urethral stump ends blind beneath it.
    • The whole urethra, stump to meatus, is the specimen.
    • The corpora, the glans and the skin stay.
  2. 02

    Perineal exposure

    Male urethrectomy after cystectomy. Step 2: Perineal exposure. Captured frame from the interactive animation.
    • High lithotomy.
    • A vertical midline incision from the base of the scrotum to just above the anus.
    • Diathermy through Colles fascia and the fat to bulbospongiosus; the muscle is divided sharply in the midline and dissected off the corpus spongiosum.
    • A self-retaining retractor is set.
  3. 03

    Encircle the bulb

    Male urethrectomy after cystectomy. Step 3: Encircle the bulb. Captured frame from the interactive animation.
    • A catheter is passed and clamped so the urethra can be felt.
    • The mid-bulbar urethra is freed all round, dorsally off the corporal bodies, and a soft drain is passed round it at this level for traction.
  4. 04

    Distal mobilisation

    Male urethrectomy after cystectomy. Step 4: Distal mobilisation. Captured frame from the interactive animation.
    • On traction, sharp and blunt dissection releases the bulbar urethra from the tunica albuginea of the corpora cavernosa, distally as far as the suspensory ligament.
    • The spongiosum comes; the tunica stays.
  5. 05

    Invert the penis

    Male urethrectomy after cystectomy. Step 5: Invert the penis. Captured frame from the interactive animation.
    • The penis is invaginated into the perineal wound, which brings the penile urethra into view.
    • It is dissected off the tunica in the same way, as far as the base of the glans.
    • The tunica albuginea of the corpora is not perforated.
  6. 06

    Meatus and glans

    Male urethrectomy after cystectomy. Step 6: Meatus and glans. Captured frame from the interactive animation.
    • The penis is returned to its normal position.
    • A circumscribing incision round the meatus takes a cuff of glans skin and is carried down through the whole glans.
    • The freed terminal urethra is tunnelled down through the perineal incision and the glans is closed in two layers.
  7. 07

    Bulbar arteries

    Male urethrectomy after cystectomy. Step 7: Bulbar arteries. Captured frame from the interactive animation.
    • Attention turns proximally.
    • The proximal bulb is freed from its posterior midline attachment and the central tendon.
    • The paired bulbar arteries are met at this level, tied and divided.
  8. 08

    Membranous urethra and delivery

    Male urethrectomy after cystectomy. Step 8: Membranous urethra and delivery. Captured frame from the interactive animation.
    • Through the deep perineal space, the membranous urethra is freed all round from the pelvic floor, sharp and blunt.
    • Diathermy is used very sparingly: the rectum lies behind, and after cystectomy bowel may be stuck to the stump.
    • The urethra is removed in one piece.
  9. 09

    Closure

    Male urethrectomy after cystectomy. Step 9: Closure. Captured frame from the interactive animation.
    • Wash out and haemostasis.
    • Bulbospongiosus is approximated, then the subcutaneous tissue and Colles fascia separately so no dead space is left, then skin.
    • A drain is optional.
    • The penis is wrapped in a self-adherent dressing and the perineum dressed with a supporter.

Derived from pelvis/UrethrectomyScene.tsx at build time: every step title and caption above is the authored ProcedureDef text, reproduced verbatim, and this page shares its readable-points renderer with the animation itself. 9 of 9 steps have a captured frame.

Text fingerprint 525db3077cd2dd62. A caption edit without a re-capture fails the production check, so the sheet and the animation cannot drift apart silently.