Urinary tract / Perineal urethrostomy At this point, the skin incision was extended in a dorsal direction to perform the regular technique. The previously practiced urethrostomy had been performed at the end of the penis, which explained the origin of the stenosis of the urethral opening (Fig. 5). As the skin is dissected in a dorsal direction and the penis is freed, the remaining skin in the dissected area should be held with a Babcock clamp without taking hold of the mucosa in order to move the penis laterally and gain access to the ischiocavernosus muscles (Fig. 6). Examination of the area revealed that neither the left nor the right ischiocavernosus muscles had been incised (Fig. 7). This was therefore done at their insertion close to the ischium to reduce bleeding (Fig. 8). This bleeding, while it does not endanger the patient’s life, can hinder exposure of the surgical site needed to continue with the procedure.
Fig. 3. Diamond-shaped incision around the stenosis.
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Fig. 4. Dissection of the scarred area.
Fig. 5. Extending the skin incision in a dorsal direction helps the surgeon achieve the
correct technique.
Fig. 6. Using a Babcock clamp enables the surgeon to displace the penis and,
Fig. 7. The left ischiocavernosus muscle (arrow) and the right ischiocavernosus
therefore, to gain access to the ischiocavernosus muscles.
muscle had not been incised in the previous procedure.
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