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Flaps in adult urethrocutaneous fistula repair: a report of two cases with the review of literature
  1. Sri Harsha Bokka1,
  2. Sreerag Kodakkattil Sreenivasan1,
  3. Ketan Mehra1 and
  4. Friji Meethale Thiruvoth2
  1. 1Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  2. 2Plastic Surgery, JIPMER, Puducherry, India
  1. Correspondence to Dr Sreerag Kodakkattil Sreenivasan; sreeragks{at}


Urethrocutaneous fistula (UCF) poses a challenge to the reconstructive urologist in terms of its location, patient’s expectations, availability of tissues for interposition, wound infection and chances of recurrence. Also, patient-related factors, such as uncontrolled diabetes, local surgery with extensive tissue loss, prior history of radiation, poor nutritional status and presence of any distal obstruction in the urethra severely affect the outcomes of a good repair with vascularised flap. We report two cases of UCF repair in adults using scrotal and gracilis muscle flaps (GMFs), their anatomic basis, technicality and advantages. The scrotal flap was used in the first case where it was freely available and GMF in second case where the patient had already undergone extensive local tissue debridement for Fournier’s gangrene and hence, we had to look for a distant flap for protection of the UCF repair. Both patients had an uneventful recovery, there were no early or late treatment-related complications and follow-up after the third and sixth month of surgery revealed no recurrence and the patients are voiding well.

  • urology
  • plastic and reconstructive surgery

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  • Contributors SHB: Acquisition of data or analysis and interpretation of data, and manuscript preparation. SKS: Planning, conduct, reporting, conception and design, and manuscript review and editing. KM: Manuscript review and editing. FMT: Manuscript review and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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