Arch Plast Surg.  2013 Sep;40(5):584-588. 10.5999/aps.2013.40.5.584.

Vascularisation of Urethral Repairs with the Gracilis Muscle Flap

• Kua EH
• Leo KW
• Ong YS
• Cheng C
• Tan BK

• KMID: 2120817
• DOI: http://doi.org/10.5999/aps.2013.40.5.584

Abstract

BACKGROUND
The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps.
METHODS
We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects.
RESULTS
After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications.
CONCLUSIONS
Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.

Keyword

Urethra; Surgical flaps; Muscles

MeSH Terms

Cicatrix
Fibrin Tissue Adhesive
Follow-Up Studies
Humans
Muscles
Reinforcement (Psychology)
Surgical Flaps
Urethra
Fibrin Tissue Adhesive