Vascularisation of Urethral Repairs with the Gracilis Muscle Flap
A 28-year-old man presented with a recurrent right mixed germ cell testicular tumour that had extended across the midline and through the tunica albuginea, ulcerating through the left scrotal skin (). The tumour involved the corpus spongiosum and was deeply adherent to the urethra. Oncologic resection resulted in a 1-cm defect over the ventral wall of the bulbar urethra. The defect was repaired over a Foley catheter with a single layer of Polydioxanone 5/0 (PDS). The urethral anastomotic site was exposed with minimal surrounding local tissue for a layered perineal closure. A pedicled gracilis muscle flap was used as an onlay to vascularise the repair site. The remnant scrotal skin was mobilised, and the skin defect could be closed primarily (). An MCU performed 3 months postoperatively showed smooth passage of urine and absence of stricture or leak (). He recovered well and was able to micturate with a good stream ().