Urethral lithiasis after neophalloplasty
Lourenço, MP1; Eliseu, M1; Temido, P1; Figueiredo, A2
1: Centro Hospitalar e Universitário de Coimbra, Portugal; 2: o Hospitalar e Universitário de Coimbra, Portugal
Objective: To describe the diagnostic and therapeutic approach of a rare clinical case of urethral lithiasis after neophalloplasty.
Material and Methods: Consultation of clinical data on the patient's process. Female to male transsexual patient, 22 years old, with nephalus of radial antebrachial flap (phalloplasty in March 2014), history of urethral fistula and urethral stricture (one year later) treated with surgical correction (fistulectomy) and suprapubic urinary diversion. Subsequently, he developed a new urethral stenosis located in the zone of the anastomosis between the neourethra and the native urethral extension. Immediately before the stenosis, there was a urethra dilatation (like a small diverticulum) with a fibous septum and with several retracted stones. The stones were fractured with holmium laser and we used the same technology to excise the fibrous septum and correct the urethral stricture. After 24 months of follow-up he presents satisfactory urinary flow with no signs of residual lithiasis.Conclusion: Endoscopic laser treatment should be considered in the treatment of neourethral lithiasis. It is also a therapeutic option in the correction of urethral stenosis caused by individualized fibrous structures.
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