Posterior reconstruction and anastomosis A. Mottrie

With a 30-cm V-Loc 3-0 barbed suture, the free edge of the fibrous layer of the Denonvilliers’ fascia is approximated to the posterior part of the sphinteric complex in a running fashion incorporating the fibrous posterior part of the rhabdosphincter and the Denonvilliers’ fascia as well as the muscular part of the urethral wall

This suture is continued back to the left in a second layer incorporating the anterior layer of the Denonvilliers’ fascia, the bladder neck, and the mucosa of the urethra

The urethrovesical anastomosis is completed using a second running V-Loc suture, starting from the left 7 o’clock position, continuing anticlockwise crossing the posterior reconstruction, and ending at the 12 o’clock position

The 30-cm V-Loc suture previously used for the two-layered posterior reconstruction is then used to complete the anastomosis running clockwise to meet the other suture at the 12 o’clock position