Journal article
Rectourethral fistula associated with two short segment urethral strictures in the anterior and posterior urethra: Single-stage reconstruction using buccal mucosa and a radial forearm fasciocutaneous free flap
Urology (Ridgewood, N.J.), Vol.67(1), pp.195-198
2006
DOI: 10.1016/j.urology.2005.08.002
PMID: 16413364
Abstract
We report a novel surgical technique used to repair a rectourethral fistula associated with two short-segment urethral strictures located in the anterior and posterior segments of the urethra in a patient with prior unsuccessful repairs.
The anterior urethral stricture was reconstructed with a ventral onlay of buccal mucosa in the exaggerated lithotomy position. In a modified prone position, the rectourethral fistula was repaired using the transrectal transsphincteric (York-Mason) technique and the posterior urethral stricture with a radial forearm fasciocutaneous free flap which was anastomosed to the inferior gluteal artery and vein. The coexistence of a rectourethral fistula and distal urethral stricture requires simultaneous repair, because the urethral pressure from the distal obstruction may compromise fistula closure. Reconstructive efforts should be tailored to minimize disruption of the urethral blood supply in patients with previous pelvic trauma. Rectal and urethral repairs should be separated by well-vascularized tissue to prevent fistula recurrence.
The radial fasciocutaneous flap may offer the reconstructive surgeon another surgical option for complex urethral stricture and rectourethral fistula reconstruction when the local blood supply is in question. Longer follow-up and more cases are needed to further evaluate the continued use of this technique.
Details
- Title: Subtitle
- Rectourethral fistula associated with two short segment urethral strictures in the anterior and posterior urethra: Single-stage reconstruction using buccal mucosa and a radial forearm fasciocutaneous free flap
- Creators
- Bradley A Erickson - Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAGregory A Dumanian - Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAMark Sisco - Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAThomas L Jang - Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAAmy L Halverson - Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAChris M Gonzalez - Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Resource Type
- Journal article
- Publication Details
- Urology (Ridgewood, N.J.), Vol.67(1), pp.195-198
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.urology.2005.08.002
- PMID
- 16413364
- ISSN
- 0090-4295
- eISSN
- 1527-9995
- Language
- English
- Date published
- 2006
- Academic Unit
- Urology
- Record Identifier
- 9984051889402771
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