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. 2015:2015:836454.
doi: 10.1155/2015/836454. Epub 2015 Sep 21.

Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique

Valary T Raup  1 , Jairam R Eswara  1 , Stephen D Marshall  2 , Steven B Brandes  2
Affiliations

Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique

Valary T Raup et al. Case Rep Urol. 2015.

Abstract

Rectourinary fistulae and urinary-cutaneous fistulae are a rare yet devastating complication. Current options for tissue interposition include rectus, gracilis, or gluteal muscle, omentum, or intestine for use in coloanal pull-through procedures. In elderly patients, testicular interposition flaps may be an excellent tissue option to use when vitalized tissue is necessary to supplement fistula repair. Elderly patients frequently have increased spermatic cord length, potentially offering a longer flap reach than use of a muscle flap. Additionally, mobilizing one of the testicles and developing it through the external inguinal ring may be a less morbid and less costly procedure than harvesting and tunneling a muscle flap. Longer follow-up and further studies are needed to determine the outcomes of this novel technique.

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Figures

Figure 1
Figure 1
Urethral fistula with visible Foley catheter.
Figure 2
Figure 2
Testicle mobilized to external ring.
Figure 3
Figure 3
Testicular interposition flap tacked down with multiple 2-0 Vicryl sutures.
See this image and copyright information in PMC

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