Staged Urethroplasty for Gunshot Urethral Injuries
Gunshot urethral trauma is rarely isolated and rarely follows a single algorithm. In this UCS lecture, reconstructive urologist Volodymyr Bondarchuk explains how wound-zone biology, urinary diversion, scar burden, surgeon experience, and patient readiness shape a reconstruction plan.
The session follows the logic of staged urethroplasty: creating a urethral plate, allowing it to mature, and completing tubularisation with buccal mucosal grafts when tissue is inadequate. Clinical cases reveal why an apparently reasonable repair can fail in injured tissue—and what deliberate, patient-centred reconstruction can achieve.
Practical takeaways include diagnostic priorities, when not to force urethral catheterisation, and why buccal mucosa has become the contemporary graft standard. A case-led session for surgeons developing judgement beyond a single operative recipe.
The session follows the logic of staged urethroplasty: creating a urethral plate, allowing it to mature, and completing tubularisation with buccal mucosal grafts when tissue is inadequate. Clinical cases reveal why an apparently reasonable repair can fail in injured tissue—and what deliberate, patient-centred reconstruction can achieve.
Practical takeaways include diagnostic priorities, when not to force urethral catheterisation, and why buccal mucosa has become the contemporary graft standard. A case-led session for surgeons developing judgement beyond a single operative recipe.