A New Biaxial Epilated Scrotal Flap for Reconstructive Urethral Surgery

Gil-Vernet, Josemaria; Arango, O.; Gil-Vernet, Alfredo; Gelabert-Más, Antoni

doi:10.1016/s0022-5347(01)64491-4

Cited by 33 publications

(20 citation statements)

References 16 publications

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“…Different urethroplasty techniques with scrotal flaps have been described [12–16]; however, the design of most was based on the understanding of classical anatomy and not on microvascular studies, which might support the existence of axial‐type vascularization and thus assure their suitability and reliability. As classically described, scrotal skin has a dual blood supply through branches from the external and internal iliac systems, respectively, distributed in anterior and posterior faces of the scrotum [2,3,8].…”

Section: Discussionmentioning

confidence: 99%

“…To ensure inclusion in the scrotal flap of the main trunk of both perineal arteries situated between the ischiocavernosus and bulbospongiosus muscles, it will be necessary to raise them within the plane of the fascia of these muscles or, even more safely, subfascially, while taking special care in the intermuscular space, as indicated in a perineally based scrotal flap urethroplasty [15].…”

Section: Discussionmentioning

confidence: 99%

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Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps

et al. 2009

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OBJECTIVE To study scrotal microvascularization and apply the findings to the design of reliable skin flaps for reconstructive surgery of complex urethral or panurethral stenoses. MATERIALS AND METHODS In 15 cryopreserved male cadavers, scrotal skin vascularization was explored using macro‐ and microdissections, and the scrotal sac made transparent using the Spalteholtz method. A meticulous descriptive analysis of the arterial network was conducted out in all cases to evaluate the number, distribution and anastomosis of the cutaneous arteries of the scrotum. RESULTS Scrotal skin is irrigated by two main vascular systems, through the inferior external pudendal arteries and the perineal arteries, which branch into multiple scrotal arteries. These arteries are distributed in three cutaneous territories, two lateral and one central, which are widely inter‐anastomosed. Each lateral territory receives an inferior external pudendal artery which accesses at the midpoint of the scrotal root and fans out to cover the entire corresponding hemiscrotum. The central cutaneous territory is vascularized through the branches of two main scrotal arteries which are a continuation of the perineal arteries and which access via the posterior face, running deeply on both sides of the septum. CONCLUSIONS The special anatomical distribution of scrotal branches stemming from perineal arteries enables the construction of adequate reliable longitudinal median island scrotal flaps for the reconstructive surgery of panurethral stenosis, as profuse axial vascularization is ensured.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps

et al. 2009

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“…[14] For reconstruction of the whole anterior urethra from the bulbomembranous portion to the meatus, the authors describe a 20 × 2.5 cm central skin flap drawn on the biaxial scrotal flap that is extended on the anterior and posterior scrotal faces [Figure 3]. The constituents include the scrotal skin, dartos, external spermatic fascia, cremasteric fibers and fascia, internal spermatic fascia and the scrotal septum (tunica vaginalis is excluded).…”

Section: Treatmentmentioning

confidence: 99%

“…These authors feel that correctly epilated scrotal skin possesses ideal characteristics for reconstructive urethral surgery from the penoscrotal angle to the prostatic apex. [14] Because of anatomical contiguity, excellent tissue availability, and tolerance in contact with urine due to abundance of sebaceous glands it is always their first option for urethroplasty. They feel that scrotal skin has a lesser chance to develop LS as compared to penile skin.…”

Section: Treatmentmentioning

confidence: 99%

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Management of panurethral strictures

2011

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Introduction:Treatment of panurethral stricture is considered a surgical challenge. We searched the literature to present a comprehensive review.Materials and Methods:A review of literature was performed using MEDLINE/PubMed database using terms “urethral stricture” and “urethroplasty”. Only articles published between 1990 and 2009 and written in English language were included in the review.Results:The main causes of panurethral strictures are previous catheterization, urethral surgery, and lichen sclerosus. The treatment of each individual case has to be tailored according to the etiology, history of previous urethral surgeries, availability of local tissues for flap harvesting, availability of appropriate donor tissue, and the expertise of the treating surgeon. In patients with complicated strictures, previously failed urethroplasties and in patients with poor quality of urethral plate two-stage surgery is a better option. In all other situations, either a flap or graft urethroplasty or if adequate tissue is not available then combination of flap and graft gives reasonable success rates.Conclusions:Panurethral strictures are relatively less common. For successful results, the surgeon should be experienced and should be familiar with all the treatment modalities.

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Use of Fasciocutaneous and Myocutaneous Flaps in Complex Urethral Reconstruction

Benson

Brandes

2019

Textbook of Male Genitourethral Reconstruction

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A New Biaxial Epilated Scrotal Flap for Reconstructive Urethral Surgery

Abstract: The excellent axial vascularization of this new flap permits successful resolution of the most complex urethral stenoses regardless of extension, location and etiology.

Cited by 33 publications

References 16 publications

Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps

Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps

Management of panurethral strictures

Use of Fasciocutaneous and Myocutaneous Flaps in Complex Urethral Reconstruction

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