Work

Excision primary anastomosis urethroplasty with gracilis muscle flap for management of complex stricture with prostatorectal fistula and failure of multiple surgeries: A case report

Year: 2025

Type: article

Abstract: Complex urethral strictures are challenging to manage, particularly after failed urethroplasty and associated complications. We report a case of a 32-year-old male with a nine-year history of urinary retention following pelvic trauma and six prior surgeries, including an iatrogenic prostatorectal fistula. The patient underwent re-do excision and primary anastomotic (EPA) urethroplasty combined with gracilis muscle flap interposition for fistula repair. Inferior pubectomy and bulbar urethra transection were performed. Postoperative recovery was uneventful, and uroflowmetry showed satisfactory flow (Qmax: 14.8 mL/s). EPA urethroplasty with gracilis flap may improve outcomes in complex urethral stricture with fistula. • EPA urethroplasty was used to manage complex stricture after multiple failed surgeries • Gracilis muscle flap provided vascular support and fistula coverage • Inferior pubectomy enabled tension-free urethral anastomosis • Postoperative Qmax was 14.8 mL/s with six-month follow-up • This case supports gracilis flap use in complex urethral repairs

Source: Urology Case Reports

DOI: 10.1016/j.eucr.2025.103238

Authors: Kristian Mohamad Daniputra, Paksi Satyagraha, Pradana Nurhadi

Institution: University of Brawijaya

Language: English

Topic: Urological Disorders and Treatments

Subfield: Urology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,160