title: The prefabricated gracilis muscle flap with full-thickness skin graft and delay for urethral channel reconstruction.
abstract: Reconstruction of complex urethral defects should provide lasting coverage, a patent tube for voiding, and a natural appearing contour with minimal morbidity to the donor and recipient sites. Many reports have emerged in the literature regarding complex urethral reconstruction through a variety of methods including anterolateral thigh flaps, radial artery forearm free flap, and other simple skin and mucosal flaps. Recently, Ozkan and Ozkan reported using a prefabricated anterolateral thigh flap for reconstruction of a traumatic urethral defect (Ozkan and Ozkan, J Plast Reconstr Aesthet Surg. 2009;62:380-384). In this report, we describe our experience with the use of a prefabricated gracilis muscle flap in a female-to-male transsexual with a complex proximal urethral stricture and distal fistula. We believe this is the first report of a prefabricated gracilis myocutaneous muscle flap being used for a long segment urethral stricture and distal fistula. We believe that this procedure offers a unique solution to a difficult problem with decreased morbidity and cosmetic advantages over other methods requiring microvascular anastomoses.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, UT, USA. stevencamp13@gmail.com
authors.forename: Steven
authors.initials: S
authors.lastname: Camp
authors.forename: Patrick
authors.initials: P
authors.lastname: Cartwright
authors.forename: Faizzi
authors.initials: F
authors.lastname: Siddiqi
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D057830:Gender-Affirming Surgery; D016038:Skin Transplantation; D013524:Surgical Flaps; D013848:Thigh; D014521:Urethra / Q000473:pathology / Q000601:surgery*; D014522:Urethral Diseases / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery; D014548:Urinary Fistula / Q000601:surgery*