Parietal Peritoneal Flap for Post-radiation Bladder Injury Repair

Inadvertent bladder injuries during pelvic surgery are not uncommon. Repair of these cystotomies are generally easy. However, post-radiation, the urinary bladder becomes contracted, friable and difficult to heal. Injuries in this setting present a treatment dilemma especially when there is absence of viable native tissue such as omentum for tissue buttress. The authors report a case of parietal peritoneal flap for post-radiation bladder injury repair based on twigs from the inferior epigastric vessels. This flap being easy to perform is believed to be a viable alternative to musculocutaneous flaps especially in the emergency setting.