The anterior sagittal transrectal approach (ASTRA) for cases associated with rectal implantation of the urethra: A retrospective review of six cases

The ASTRA approach proved to be useful for cases of rectal implantation of the urethra. No complications related to anterior sphincter incision were documented. We believe it should be regarded as the treatment of choice for cases alike ours.307Figure. Operative procedure step by step: A. Patient position. B. Urethra separated from anus. C. Anterior rectal wall and perineal body reconstruction. D. Urethral stump anastomosed to a perineal skin flap.