fig1

Figure 1. Total anatomical reconstruction technique: the posterior reconstruction is performed in a triple layer by using a 3/0 barbed suture. The first layer involves Denonvilliers’ fascia and the median raphe, the second the retrotrigonal fascia and the median raphe, and the third the bladder neck and the rhabdosphincter. The urethra-vesical anastomosis is made by using two 3/0 barbed hemi-running sutures, involving the full thickness of either the bladder or the urethra. The anterior reconstruction consists of two layers of 3/0 barbed running sutures. The first layer involves the muscular fibres of the bladder and the peri-urethral tissue. The second involves the vesical apron and the portion of the endopelvic fascia that covers the dorsal vein complex while involving the pubo-prostatic ligaments.