Is a pedicular flap coupled to the double turnover flaps urethroplasty suitable for urethral–perineal reconstruction? Considerations about a relapsing urethral–cutaneous fistula condition

This study explores a surgical approach to fix a recurring connection between the urethra and skin in the perineum (the area between the genitals and anus) in a patient with a spinal cord injury. The approach combines two techniques: 'Turn over flaps urethroplasty' to rebuild the urethra, and a 'Pedicular fasciocutaneous flap' from the gluteal fold to cover and protect the reconstructed area. Unlike traditional methods that rely on identifying specific blood vessels, this flap uses a broader network of small vessels for its blood supply.

• 1
  The combined technique resulted in a well-healed perineal area and a functional, reconstructed urethra.
• 2
  The 'Pedicular flap' provides a reliable alternative for recurrent urethral fistula treatment, especially in patients with spinal cord injuries.
• 3
  The study hypothesizes the flap survives due to a network of microperforators when major perforators are absent.