Cystourethroplasty is a general term referring to procedures reconstructing the anatomy of the junction between the bladder and urethra (bladder or vesical neck). The bladder neck is the lowest portion of the bladder and merges with the urethra. Cysto or vesical is a term referring to the bladder, and cystourethroplasty is the repair or reconstruction (plastic surgery) of the bladder neck. There is a wide diversity of operations addressing problems arising at the bladder neck. Major surgical procedures result in reconstruction of congenital abnormalities. Minor procedures are also performed to relieve scarring (contractures) of the bladder neck. In fact, cystourethroplasty procedures are performed to repair congenital abnormalities, complications following prostatectomy, and traumatic injury.
In male adults, bladder neck reconstruction may be performed to repair abnormalities associated with prior prostate surgery and in female adults to treat urinary incontinence. In men, incontinence occurs frequently following a radical prostatectomy. (The incidence of incontinence is low after transurethral prostatectomy.) Traumatic injury, sometimes involving rupture of the bladder, can also necessitate repair of the bladder, bladder neck, and urethra. In men, urethral injury is sometimes observed in that part of the urethra extending from the bladder neck to just below the prostate. This area is called the posterior urethra. Injury here occurs as a result of a pelvic fracture or straddle injury.
Young men requiring a series of surgeries to correct congenital abnormalities, individuals with exstrophy, or those individuals sustaining a ruptured bladder during an accident are among those most likely to undergo a cystourethroplasty of the bladder neck.