Skip to main content

Perineal Bookwalter — Jordan Retractor

The perineal Bookwalter is a specialized ring retractor system for deep posterior urethroplasty, developed in close collaboration with Gerald H. Jordan (Eastern Virginia Medical School).

Design​

  • Bookwalter-style circumferential ring mounted to a table-fixed post
  • Specific perineal blades that hook under the ischial tuberosities
  • Thigh retractors that pull the legs outward, creating the exaggerated lithotomy cone

Why It Matters​

Posterior urethroplasty requires deep, stable exposure maintained for hours. Standard self-retaining systems (Lone Star, Adson-Beckman) cannot achieve the depth needed to reach the membranous urethra in a patient in exaggerated lithotomy. The perineal Bookwalter creates the operative cone, secures it to the table, and holds the exposure rock-steady through long, complex cases.

Key Uses​

  • Posterior urethroplasty — the signature application
  • Perineal prostatectomy (when used)
  • Redo bulbar urethroplasty
  • Complex perineal reconstruction

History​

Gerald Jordan — one of the founders of the modern US reconstructive tradition through the Devine-Jordan school at EVMS — co-developed this retractor system to operationalize the exposure required for the posterior urethroplasty techniques he championed. The system remains the gold-standard exposure for deep perineal reconstruction across the field.

See also: Turner-Warwick Ryder, Lone Star Retractor, Surgical Genealogy.