One-stage replacement of an extended urethral defect after gunshot injury with a combined flap

Sinelnikov L.M., Protoshchak V.V., Proskurevich E.I., Galyuk D.A., Paronnikov M.V., Kislitsyn P.O., Kushnirenko N.P., Karpushchenko E.G., Orlov D.N.

FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia

Publications devoted to single-stage total substitution of long-segment urethral defects are sporadic and characterized by a small number of observations. The complexity of the clinical case presented in this article is determined by its etiology (combined mine-blast injury with traumatic amputation of the scrotum and both testicles, complicated by the formation of a urethro-perineal fistula) and the length of the urethral defect, measuring 7 cm. A 24-year-old male underwent single-stage substitution urethroplasty 6 months after the injury, involving excision of the urethral fistula and neourethra formation through dorsal grafting of a buccal mucosal graft combined with ventral transposition of a transferred preputial flap on a fascial pedicle. This technique may be considered a possible alternative to multi-stage urethroplasty, provided there is careful patient selection, taking into account their age, preferences, and the availability of relevant experience at the urological center.

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About the Authors

Corresponding author: L.M. Sinelnikov – PhD, head of the department of the clinic of urology of the FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Saint Petersburg, Russia; e-mail: sinelurolog@mail.ru

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