Korean J Urol.  2015 Jul;56(7):478-486. 10.4111/kju.2015.56.7.478.

Tissue transfer techniques in reconstructive urology

• Bryk DJ
• Yamaguchi
• Zhao LC

• KMID: 2160644
• DOI: http://doi.org/10.4111/kju.2015.56.7.478

Abstract

Tissue transfer techniques are an essential part of the reconstructive urologist's armamentarium. Flaps and graft techniques are widely used in genital and urethral reconstruction. A graft is tissue that is moved from a donor site to a recipient site without its native blood supply. The main types of grafts used in urology are full thickness grafts, split thickness skin grafts and buccal mucosa grafts. Flaps are transferred from the donor site to the recipient site on a pedicle containing its native blood supply. Flaps can be classified based on blood supply, elevation methods or the method of transfer. The most used flaps in urology include penile, preputial, and scrotal skin. We review the various techniques used in reconstructive urology and the outcomes of these techniques.

Keyword

Mouth mucosa; Reconstructive surgical procedures; Surgical flaps; Tissue transplantation; Urologic surgical procedures

MeSH Terms

Genitalia/surgery
Humans
Mouth Mucosa/transplantation
Reconstructive Surgical Procedures/*methods
Skin Transplantation/methods
*Surgical Flaps
Tissue Transplantation/*methods
Ureter/surgery
Urethra/surgery
Urologic Surgical Procedures/*methods

Figure

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  Fig. 1 Patient with Fournier's gangrene. Split thickness skin graft was used for scrotal reconstruction.

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  Fig. 2 Patient after partial penectomy. Split thickness skin graft used for glans reconstruction.

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  Fig. 3 Split thickness skin graft on reconstructed glans after partial penectomy, one week after surgery.

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  Fig. 4 Glans reconstruction using split thickness skin graft after partial penectomy, two months after reconstruction.

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  Fig. 5 Dorsal onlay urethroplasty.

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  Fig. 6 First stage urethroplasty using buccal mucosa graft. The narrowed urethral plate is at the midline and buccal mucosa grafts are on both sides.

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  Fig. 7 Urethroplasty using penile skin flap.

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  Fig. 8 Robotic-assisted buccal mucosa graft ureteroplasty for ureteral stricture.

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  Fig. 9 Endoscopic view after placement of buccal mucosa graft for ureteral stricture. BMG, buccal mucosa graft.

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