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Propeller Flap Perineal Urethrostomy Revision.
Michael L Schulster1, Geolani W Dy1, Neil M Vranis2
1Department of Urology, NYU Langone Health, New York, NY.
Urology
|December 14, 2020
Summary
This study presents a novel posterior thigh propeller flap technique for perineal urethrostomy (PU) revision. The method successfully treated complex cases, preventing stenosis and improving patient quality of life.
Area of Science:
- Urology
- Reconstructive Surgery
Background:
- Perineal urethrostomy (PU) revisions are challenging due to potential stenosis.
- Complex cases require innovative surgical techniques for successful outcomes.
Observation:
- A novel technique utilizing a posterior thigh propeller flap for PU revision was employed.
- The flap was designed based on consistent posterior thigh perforators for optimal length and thickness.
- The stenotic PU was incised, and the flap was elevated, rotated, and tubularized to fit the defect.
Findings:
- The patient demonstrated successful voiding with a patent PU after 17 months of follow-up.
- Quality of life improved, with post-void residuals consistently below 100cc.
- Hospitalizations for urinary tract infections decreased significantly, with only one outpatient-treated infection reported.
Implications:
- This posterior thigh propeller flap technique offers a viable solution for complex perineal urethrostomy revisions.
- The use of a distant local flap minimizes morbidity and achieves excellent clinical results.
- This approach provides a new option for reconstructive surgery in challenging urethral stricture cases.
