Extraperitoneal J.U. Stolzenburg

Apical dissection follows which is a 5 step procedure.

The first step is the cutting of Santorini venous plexus.

The second step, is the cutting of the border between the striated layer of the sphingter and the apex of the prostate.

The third step of dissection, is the cutting of the inner layer of urethral smooth muscle, entering the lumen of the urethra.

The forth step of dissection is the cutting of the posterior urethral mucosa, distally to the verum montanum.

The final and fifth step of dissection is done from laterally. Its goal is to protect the more distal attachments of the bundles to the apex. Using sharp and blind dissection the bundles are separated from the posterior urethra bilaterally. Following posterior release of the bundles, urtethra is free to be completely excised safely.