Construction of female neourethra using a flipped anterior bladder wall tube.

Two cases in which a neourethra was constructed using a flipped anterior bladder wall tube are reported. One girl had lost her urethra secondary to a major urethrovaginal injury from blunt pelvic trauma, an in the other, the urethra had sloughed after cloacal reconstruction. Both patients had a closed bladder neck/proximal urethra and were received with a suprapubic cystostomy. A neourethra was constructed from an anterior bladder wall flap based distally. The flap was tubularized and flipped caudally to the site of the original external urethral meatus. Both girls are continent--one voids normally and the other is managed by clean intermittent catheterization. The flipped anterior bladder wall tube technique for construction of a female neourethra is suitable in patients with an absent urethra, particularly when the bladder neck/proximal urethra is closed.