Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique

Rectourinary fistulae and urinary-cutaneous fistulae are a rare yet devastating complication. Current options for tissue interposition include rectus, gracilis, or gluteal muscle, omentum, or intestine for use in coloanal pull-through procedures. In elderly patients, testicular interposition flaps m...

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Main Authors: Valary T. Raup, Jairam R. Eswara, Stephen D. Marshall, Steven B. Brandes
Format: Article
Language:English
Published: Hindawi Limited 2015-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2015/836454
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spelling doaj-72e2b2ab6ad243ecbe369bba241a35182020-11-25T00:04:40ZengHindawi LimitedCase Reports in Urology2090-696X2090-69782015-01-01201510.1155/2015/836454836454Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical TechniqueValary T. Raup0Jairam R. Eswara1Stephen D. Marshall2Steven B. Brandes3Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USADivision of Urology, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USADivision of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USADivision of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USARectourinary fistulae and urinary-cutaneous fistulae are a rare yet devastating complication. Current options for tissue interposition include rectus, gracilis, or gluteal muscle, omentum, or intestine for use in coloanal pull-through procedures. In elderly patients, testicular interposition flaps may be an excellent tissue option to use when vitalized tissue is necessary to supplement fistula repair. Elderly patients frequently have increased spermatic cord length, potentially offering a longer flap reach than use of a muscle flap. Additionally, mobilizing one of the testicles and developing it through the external inguinal ring may be a less morbid and less costly procedure than harvesting and tunneling a muscle flap. Longer follow-up and further studies are needed to determine the outcomes of this novel technique.http://dx.doi.org/10.1155/2015/836454
collection DOAJ
language English
format Article
sources DOAJ
author Valary T. Raup
Jairam R. Eswara
Stephen D. Marshall
Steven B. Brandes
spellingShingle Valary T. Raup
Jairam R. Eswara
Stephen D. Marshall
Steven B. Brandes
Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
Case Reports in Urology
author_facet Valary T. Raup
Jairam R. Eswara
Stephen D. Marshall
Steven B. Brandes
author_sort Valary T. Raup
title Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
title_short Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
title_full Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
title_fullStr Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
title_full_unstemmed Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
title_sort testicular interposition flap for repair of perineal urinary fistulae: a novel surgical technique
publisher Hindawi Limited
series Case Reports in Urology
issn 2090-696X
2090-6978
publishDate 2015-01-01
description Rectourinary fistulae and urinary-cutaneous fistulae are a rare yet devastating complication. Current options for tissue interposition include rectus, gracilis, or gluteal muscle, omentum, or intestine for use in coloanal pull-through procedures. In elderly patients, testicular interposition flaps may be an excellent tissue option to use when vitalized tissue is necessary to supplement fistula repair. Elderly patients frequently have increased spermatic cord length, potentially offering a longer flap reach than use of a muscle flap. Additionally, mobilizing one of the testicles and developing it through the external inguinal ring may be a less morbid and less costly procedure than harvesting and tunneling a muscle flap. Longer follow-up and further studies are needed to determine the outcomes of this novel technique.
url http://dx.doi.org/10.1155/2015/836454
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AT jairamreswara testicularinterpositionflapforrepairofperinealurinaryfistulaeanovelsurgicaltechnique
AT stephendmarshall testicularinterpositionflapforrepairofperinealurinaryfistulaeanovelsurgicaltechnique
AT stevenbbrandes testicularinterpositionflapforrepairofperinealurinaryfistulaeanovelsurgicaltechnique
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