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Repair of a fistula between the bladder and the perineal skin by femoral gracilis flap interposition
Author(s) -
Osawa Shuichi,
Nishimura Taiji,
Akimoto Masataka,
Abe Hiroyuki,
Hamasaki Tsutomu,
Kuroda Shuichi
Publication year - 2001
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.1442-2042.2001.00257.x
Subject(s) - medicine , surgery , cystography , fistula , urinary bladder , catheter , perineum , pelvic exenteration , urinary system , anatomy
The successful repair of a fistula between the bladder and the perineal skin using a femoral gracilis flap is reported. A 70‐year‐old woman, who 10 years previously had undergone a total hysterectomy for uterine cancer, developed a fistula between the bladder and the perineal skin after she underwent Mile's operation for rectal cancer. Initially, an attempt was made to repair the fistula by the transabdominal approach. This failed, probably because of the lack of supporting tissue between the bladder and the perineal skin. The second repair was performed with plastic surgeons. A secure three‐layer bladder closure was accomplished. A right femoral gracilis flap was developed and rotated 180° to fill the defect in the skin and subcutaneous tissue. Four weeks after surgery, cystography revealed no fistula or urinary leakage and the drainage catheter was removed. Femoral gracilis flap interposition was successful for repair of a fistula between the bladder and the perineal skin when there was no supporting tissue due to extensive exenteration in the surgical removal of rectal cancer and after other repair procedures had been unsuccessful.