Figure 1.

(A) A short midline perineal incision bifurcated posteriorly gives improved access to the membranous urethra. (B) The urethra is circumferentially mobilised proximally to the point of obliteration and distally to the crus. Incision of the posterior attachments and urethra facilitates the access. (C) The urethra is transected at the point of obliteration and mobilised distally beyond the crus. (D) The corporal body is separated in bloodless planes from the crus distally for 4–5 cm. Separation beyond this point is generally not possible. (E) An inferior pubectomy using osteotomes. Only a small channel of the bone requires removal between the separated corporal bodies. (F) Supra-crural re-routing of the urethra mobilised only as far as the suspensory ligament allows it to course to the high-riding prostate. From [19], with permission.