RECONSTRUCTION OF URETHRAL DEFECT DUE TO PERINEAL SORE USING PEDICLED SCROTAL SEPTAL FLAP

ABSTRACT

Reconstruction of the male urethra is required for a multitude of congenital anomalies, such as hypospadias and epispadias, as well as fort acquired lesions such as stricture disease and trauma. No method is appropriate for all types of repair of the urethra. A successful surgical reconstruction of the urethra is the result of a proper operative selection that depends on the site and length of the disrupted urethra and also depends on, as well as the experience of the surgeon. Reconstruction of the urethra has been performed by the use of homografts, silicone tubes, grafts taken from the bladder mucosa. But serious postoperative problems, such as urinary fistula, urethrostenosis, stricture of the site of urethral anastomosis, and diverticulum formation, are not uncommon. Especially, reconstruction of Proximal urethra is very difficult because of limitations of operation field exposure and flap transfer. However, the hairless median scrotal skin flap with the scrotal septum attached, rich in neurovascular plexus, is ideal material for creating a new urethra without interference to its blood supply and other complications. We experienced a successful reconstruction of the proximal urethral defect in about 8cm length and perineal sore with pedicled scrotal septal flap and gracilis musculocutaneous flap, respectively.