Use of Martius flap in the complex female urethral surgery

Objectives were to evaluate safety and patient reported perception of the Martius fibroadipose flap for complex female urethra reconstruction.

Patients operated with a Martius flap were contacted again via telephone to rate their self-perception on cosmetic appearance, pain or numbness of the flap harvest site.

37 women (mean age of 46.8 yrs.) were operated with Martius flaps. Complications were limited to bleeding from the flap bed in 19% (7/37); hematomas - 5.4% (2/37); and lymphorrhea from the labial incision in 13.5% (5/37) and labial wound infection in 5.4% of cases (2/37). For self-perception 65% of patients (24/37) were phone interviewed (mean follow up - 54.2 months). Only 17% of women (4/24) complained to cosmetic problems. Two patients (8%) complained to a periodical mild pain. And 12.5% (3/24) of the women had decreased sensation or numbness at the labia.

Martius flap is safe and it is not causing significant complications during female urethral reconstruction. However, an informed consent for decreased sensation and numbness at the flap harvesting area should be obtained.