Gracilis Muscular Flap for Large Urethral Defect

We report the use of Gracilis muscle to repair a large urethral defect. A 57-year-old-man with rectal cancer underwent abdominoperineal resection including part of the prostate and seminal vesicle. Soon after surgery, he presented with massive urinary leakage from the prostatic urethra. Conservative treatment for one month failed. The defect of the prostatic urethra, measuring 2.5 cm in diameter, was closed with the right gracilis muscular flap. About five years and 6 months after surgery, the patient can void spontaneously without incontinence. Cystoscopy demonstrated good epithelization of the reconstructed urethra without stenosis. The gracilis muscular flap was easily available and useful for closure of a large urethral defect.