Reconstruction of a near total male urethral defect with a microvascular free flap

Infection-induced urethral defect treated by urethral reconstruction with a radial forearm flap

Abstract A 47-year-old man was admitted with the chief complaint of a urethral defect. An approximately 17-cm defect of the urethra seemed to have been occurred by the infection of implanted foreign bodies in the penile skin. Reconstruction of the urethra and the ventral skin was performed with a free radial forearm flap. A fistula formed at the proximal anastomosis after the operation, but was controlled conservatively. Urethral stricture at the proximal anastomosis subsequently developed. A urethral stent made of shape memory alloy was placed with the preservation of voiding function.

Gunshot wounds to the male genitalia

Fifty consecutive cases of gunshot wounds to the male external genitalia were treated by the Tulane University Urology Service at the Medical Center of Louisiana in New Orleans. Fifty percent of the patients had significant associated injuries. Eight anterior urethral injuries were identified, all by retrograde urethrography. Five of 17 testicular injuries were salvaged with conservative operative technique. Review of this series suggests that good functional integrity of the male genitalia after gunshot injury can be maintained by following a strict diagnostic and therapeutic regimen.