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Updated: May 7, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Vascularisation of urethral repairs with the gracilis muscle flap
Ee Hsiang Jonah Kua1, Kah Woon Leo, Yee Siang Ong
1Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.
Background:
The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps.
Methods:
We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects.
Results:
After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications.
Conclusions:
Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.
