scholarly journals Reconstruction of a Wide Defect in the Prostatic Urethra after Abdomino-Perineal Amputation Using Buccal Mucosa Free Graft and Pedicled Gracilis Muscle Flap

2020 ◽  
pp. 1-3
Author(s):  
Ivan Couto González ◽  
Antonio Taboada-Suárez ◽  
Beatriz Brea-García ◽  
Camilo García-Freire ◽  
Ignacio Vila ◽  
...  
Keyword(s):  
Buccal Mucosa ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
Free Graft ◽  
Peripheral Tissues ◽  
Gracilis Muscle Flap ◽  
Buccal Mucosa Graft ◽  
Substance Loss ◽  
The Stability ◽  
Urethral Defect

Lesions with significant substance loss in the prostatic segment of the urethra can represent a reconstructive challenge, especially when peripheral tissues are damaged or poor-vascularized. We present an infrequent clinical case in which a prostatic urethral defect of 2.6cm in length following abdomino-perineal amputation was repaired using a free buccal mucosa graft which was stabilized with a muscular gracilis flap. Complementing the buccal mucosa graft with a well-vascularised support the stability of the graft could be enhanced and the rates of fistula or strictures reduced.

scholarly journals Case Report: Use of reinforced buccal mucosa graft over gracilis muscle flap in management of post high intensity focused ultrasound (HIFU) rectourethral fistula

F1000Research ◽  
2017 ◽  
Vol 5 ◽  
pp. 2891 ◽  
Author(s):  
Shrikant Jai ◽  
Arvind Ganpule ◽  
Abhishek Singh ◽  
Mohankumar Vijaykumar ◽  
Vinod Bopaiah ◽  
...  
Keyword(s):  
Case Report ◽  
Buccal Mucosa ◽  
Focused Ultrasound ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
High Intensity Focused Ultrasound ◽  
Rectourethral Fistula ◽  
Gracilis Muscle Flap ◽  
Buccal Mucosa Graft ◽  
Free Closure

High intensity focused ultrasound (HIFU) has come forward as alternative treatment for carcinoma of the prostate. Though minimally invasive,HIFUhas potential side effects. Urethrorectal fistula is one such rare side effect. Management of these fistulas has been described by Vanni et al. This case report describes points of technique that will help successful management of resilient rectourethral fistula. Urinary and faecal diversion in the form of suprapubic catheter and colostomy is vital. Adequate time between stoma formation, fistula closure and then finally stoma closure is needed. Lithotomy position and perineal approach gives best exposure to the fistula. The rectum should be dissected 2cm above the fistula; this aids in tension free closure of the rectal defect. Similarly buccal mucosal graft was used on the urethra to achieve tension free closure. A good vascular pedicle gracilis muscle flap is used to interpose between the two repairs. This not only provides a physical barrier but also provides a vascular bed for BMG uptake. Perfect haemostasis is essential, as any collection may become a site of infection thus compromising results.  We strongly recommend rectourethral fistula be directly repaired with gracilis muscle flap with reinforced buccal mucosa graft without attempting any less invasive repairs because the “first chance is the best chance”.

scholarly journals Case Report: Use of reinforced buccal mucosa graft over gracilis muscle flap in management of post high intensity focused ultrasound (HIFU) rectourethral fistula

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2891
Author(s):  
Shrikant Jai ◽  
Arvind Ganpule ◽  
Abhishek Singh ◽  
Mohankumar Vijaykumar ◽  
Vinod Bopaiah ◽  
...  
Keyword(s):  
Case Report ◽  
Buccal Mucosa ◽  
Focused Ultrasound ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
High Intensity Focused Ultrasound ◽  
Rectourethral Fistula ◽  
Gracilis Muscle Flap ◽  
Buccal Mucosa Graft ◽  
Free Closure

High intensity focused ultrasound (HIFU) has come forward as alternative treatment for carcinoma of the prostate. Though minimally invasive,HIFUhas potential side effects. Urethrorectal fistula is one such rare side effect. To our knowledge this is first case in which rectourethral fistula secondary to HIFU was repaired with buccal mucosa graft (BMG) over a harvest bed of gracilis flap. This case report describes points of technique that will help successful management of resilient rectourethral fistula. Urinary and faecal diversion in the form of suprapubic catheter and colostomy is vital. Adequate time between stoma formation, fistula closure and then finally stoma closure is needed. Lithotomy position and perineal approach gives best exposure to the fistula. The rectum should be dissected 2cm above the fistula; this aids in tension free closure of the rectal defect. Similarly buccal mucosal graft was used on the urethra to achieve tension free closure. A good vascular pedicle gracilis muscle flap is used to interpose between the two repairs. This not only provides a physical barrier but also provides a vascular bed for BMG uptake. Perfect haemostasis is essential, as any collection may become a site of infection thus compromising results.  We strongly recommend rectourethral fistula be directly repaired with gracilis muscle flap with reinforced buccal mucosa graft without attempting any less invasive repairs because the “first chance is the best chance”.

Gracilis muscle flap for aesthetic reconstruction in the head and neck region

Microsurgery ◽  
2005 ◽  
Vol 25 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Georg M. Huemer ◽  
Thomas Bauer ◽  
Gottfried Wechselberger ◽  
Thomas Schoeller
Keyword(s):  
Head And Neck ◽  
Muscle Flap ◽  
Neck Region ◽  
Gracilis Muscle ◽  
Head And Neck Region ◽  
Gracilis Muscle Flap
Sign in / Sign up

Export Citation Format

Share Document