title: [Closure of large vesico--urethra--vaginal defect with pedicled myocutaneous gracilis flap (author's transl)].
abstract: Operative treatment of large bladder-vaginal-urethral defects is a problem, especially after radiogenic tissue damage. Successful reconstruction of the defect is only possible when healthy and sufficiently perfused tissue is used. This may be obtained by the interposition of pedicles omentum flap. Contrary to the use of a pedicled myocutaneous gracilis muscle flap this transabdominal procedure is a more extensive operation. The use of myocutaneous flaps offers healthy tissue for defect repair in a sufficient amount. Sufficient perfusion guarantees a safe healing and stability of the reconstruction. An advantage is that no functional defects result from this procedure. In reconstruction of the bladder floor and neck a tissue cushion is formed which seems to improve postoperative continence.
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D013524:Surgical Flaps; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000601:surgery*
vernacular_title: Verschluss eines grossen Blasen-Harnröhren-Scheidenwanddefektes durch gestielten myokultanen Musculus-gracilis-Lappen.