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Page 6 of 11 El-Ghoneimi et al. Plast Aesthet Res 2022;9:39 https://dx.doi.org/10.20517/2347-9264.2021.101
Figure 4. Second stage: tunneling of the tubularized bladder mucosa free graft. (A) With the need for a 16 cm urethroplasty, the
erection test showed the absence of residual curvature. (B) Creation of the tunnel: the perineal dissection is done by sharp instrument
until the exposure of the albuginea of the corpus cavernosa. A midline incision is done at the expected site of the meatus. Progressive
dilatation with metallic bougie is done to achieve an easy passage of a bougie equal to Ch 18. (C) Tubularization of the free graft around
a 16 Ch Foley catheter.
Figure 5. Tunneling of the tubularized graft from dital to proximal. Carefully positioning the suture line of the graft opposite to the
corpus cavernosum, a large anastomosis is done between the graft and the spatulated perineal healthy urethra. (A and B) The distal
anastomosis is done on the healthiest part of the glans.
