Difficult urethral reconstruction

A new technique using the pedicled island flap of penile skin for total urethral reconstruction is described. The technique consists of using a long, modified flap of more than 15 cm in length and was utilized in 6 cases of total urethral stricture. Four cases resulted in an excellent outcome, while 2 had fistula with anastomotic stricture. The technique is useful in reconstruction of the total urethra, but the utmost care is needed in the dissection to preserve the viability of the pedicle.