APPENDIX INTERPOSITION IN THE TREATMENT OF SEVERE POSTERIOR URETHRAL INJURIES

The aim of this study was to investigate the applicability of the Mitr ofanoff principle in the treatment of severe posterior urethral injuri es and determine the feasibility of this technique with its early and late postoperative results. A total of 27 New Zealand rabbits (12 male and 15 female) was used (mean weight 2,272 +/- 343 gm.). Using genera l anesthesia the proximal part of the posterior urethra was transected completely and a 1 cm, segment was excised. A 2 cm. segment of append ix with its intact vascular pedicle was meticulously mobilized and ana stomosed to the proximal and distal site of the urethra. Excretory uro grams, voiding cystourethrograms, urodynamic investigation and histopa thological examination were performed postoperatively. The fertility o f the male rabbits was examined in the late postoperative period as we ll. These results were compared with those of a control group. There w as no problem concerning voiding patterns in the pedicled appendiceal flap group, Excretory urograms revealed a properly functioning urinary system. Voiding cystourethrograms showed a normal bladder capacity an d voiding pattern, and an intact urethra. Urodynamic analysis was with in normal limits except for a decrease in bladder volume. An intact ur ethral lumen without any strictures or fibrosis was demonstrated histo pathologically. No calculus, mucus formation or urinary tract infectio n was observed in the late postoperative period. Fertility problems we re noted in male rabbits, This animal experiment suggested that the pe dicled appendiceal flap technique could be used for the treatment of s evere forms of posterior urethral injuries.