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Step 5. Apical dissection J.U. Stolzenburg
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Step 5. Apical dissection
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- Assisting nurse should pull out and re-insert the catheter after Stantorini suture have passed through dorsal venous plexus , to ensure that catheter has not been incorporated into the stitch.
- Apical dissection 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 sphincter and the apex of the prostate. Gradual, circumferential dissection of this layer of the urethra, in addition to a continuous mild traction of the prostate cranially, will elongate the opening between prostate and sphincter and will allow a maximum preservation of urethral length.
- 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 verumontanum.
- The final and fifth step of dissection is the dissection of the posterior urethra, which is performed dorsolaterally taking care to avoid injury to the adjacent bundles bilaterally.
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