Robotic Vesico-Vaginal Fistula Repair.

Vesico-vaginal fistulae require complex reconstructions and robotic assistance can be beneficial in obtaining successful outcomes. In this video, we demonstrate two of our techniques of vesicle-vaginal fistula repair, one with transverse cystotomy and other with vertical cystotomy, along with salient steps of the procedure. The indication, preparation, instrumentation, and surgical steps are also discussed along with a review of available literature.

"Primary" bulbar urethral ischemic necrosis following pelvic fracture urethral injury: A rare surgical challenge.

Ischemic necrosis of the bulbar urethra in a patient with pelvic fracture urethral injury without a prior history of surgical intervention is extremely rare and results in long-segment obliterative strictures that are difficult to manage. Instead of the more traditional approach of vascular reconstruction followed by transpubic end-to-end urethroplasty, these patients are better managed by up-front urethroplasty with a tubed flap or as a staged procedure with grafting and tubularization. Herein, we report a case of primary bulbar urethral ischemic necrosis due to pelvic fracture managed with tubularized preputial flap (McAninch flap) urethroplasty.