Gluteal-fold adipofascial perforator flap transposition for rectourethral fistula reconstruction

Objective: If a rectourinary fistula does not close spontaneously, it requires surgical closure. We present our experience of rectourethral fistula reconstruction using a gluteal-fold perforator flap, resulting in a successful outcome. Patient and Methods: The present was a 64-year-old man with prostate cancer who underwent radical prostatectomy. However, he developed rectourinary fistula, which required surgical closure. A dissection was undertaken to divide the fistula tract, and the rectal and urethral defect were closed. A 12.0x3.0-cm gluteal-fold adipofascial perforator flap was harvested and placed in the space between the rectum and urethra. Results: The viability of all flaps was favorable, without infection or necrosis. The patient could walk the next day, and was discharged two weeks later without fecaluria or liquid stool. Conclusions: We conclude that the glutealfold adipofascial perforator flap offers excellent functional advantages in rectourethral fistula reconstruction with minimal morbidity at the donor site. Rectourethral fistula reconstruction using gluteal-fold flap 1 Abstract 1 Objective: If a rectourinary fistula does not close spontaneously, it requires surgical 2 closure. We present our experience of rectourethral fistula reconstruction using a 3 gluteal-fold perforator flap, resulting in a successful outcome. Patient and Methods: 4 The patient was a 64-year-old man with prostate cancer who underwent radical 5 prostatectomy. However, he developed rectourinary fistula, which required surgical 61 Objective: If a rectourinary fistula does not close spontaneously, it requires surgical 2 closure. We present our experience of rectourethral fistula reconstruction using a 3 gluteal-fold perforator flap, resulting in a successful outcome. Patient and Methods: 4 The patient was a 64-year-old man with prostate cancer who underwent radical 5 prostatectomy. However, he developed rectourinary fistula, which required surgical 6 closure. A dissection was undertaken to divide the fistula tract, and the rectal and 7 urethral defect were closed. A 12.0x3.0-cm gluteal-fold adipofascial perforator flap 8 was harvested and placed in the space between the rectum and urethra. Results: 9 The viability of all flap was favorable, without infection or necrosis. The patient 10 could walk the next day, and was discharged two weeks later without fecaluria or 11 liquid stool. Conclusions: We conclude that the gluteal-fold adipofascial perforator 12 flap offers excellent functional advantages in rectourethral fistula reconstruction with 13 minimal morbidity at the donor site. 14