Urethroplasty of Urethral Defect with Longitudinal Tubed Flap of Scrotal Skin after Fournier's Gangrene (Necrotizing Fascitis).
- Author:
Hee Joon MIN
1
;
Tai Suk ROH
;
Ji Ye KIM
;
Sug Won KIM
Author Information
1. Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea. sugwonkim@yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Urethroplasty;
Urethral reconstruction;
Fournier's Gangrene
- MeSH:
Aged;
Cicatrix;
Debridement;
Diabetes Mellitus;
Fascia;
Fournier Gangrene;
Humans;
Skin;
Tissue Donors
- From:Journal of the Korean Society of Plastic and Reconstructive Surgeons
2010;37(5):667-670
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The management of urethral defect represents one of the most challenging clinical problems in uroplastic surgery. Especially for defect after Fournier's Gangrene, optimal management is still a hard problem. During extensive urethral reconstruction, to overcome the poor vascularity due to periurethral scarred tissue and limitation of the choice of local flap, we report our experience with one-stage reconstruction of urethral defect using a longitudinal tubed flap of scrotal skin. METHODS: A 72-year-old man with several years of diabetes mellitus history visited for swelling and pain of scrotal area. After diagnosis of Fournier's Gangrene, radical debridement was performed and 6 cm of urethral defect on border of penile-scrotal ventral area was made. Rectangular scrotal skin flap (6 x 2.5 cm) based on external spermatic fascia was elevated and tubed longitudinally. After transfer the flap to the defect area, end-to-end anastomosis was performed bilaterally. RESULTS: 4 weeks after the operation, the patient started voiding him-self and urethrography showed good fluence of contrast agent. Long term evaluation reveals stable performance characteristics without any complications. CONCLUSION: We suggest a one-stage reconstruction of extensive urethral defect using a longitudinal tubed flap of scrotal skin. Advantages of this procedures are simple, one-stage reconstruction with the reliable scrotal skin flap based on external spermatic fascial vasculature, and no donor morbidity.
