Fig. 3.

Overview of the posterior reconstruction (PR) and vesicourethral anastomosis using the interlocked V-LOC suture. a) the left-arm of the hybrid suture is passed initially at the 5-o’clock position of the retrotrigonal tissue. The suture is pulled through until the inter-twined loops oppose the tissue providing resistance. (red *) Using 3 consecutive bites, the PR helps approximate the edge of the bladder neck to the peri-urethral tissue. b) The left arm of the suture is then passed transmurally through the 6-o’clock bladder neck and used to commence a standard Van Velthoven anastomosis. The right arm is then used to close the right-sided VUA. c) A visual cystogram with 300mL of saline is performed to ensure no leakage afterwhich the needles are cut and the remaining suture is left in-situ (no knot).