Wada Naoki, Takagi Haruka, Ishimaru Taichiro, Kikuchi Daiki, Ohtani Miyu, Kakizaki Hidehiro, Yamao Takeshi, Hayashi Toshihiko
Department of Renal and Urologic Surgery Asahikawa Medical University Asahikawa Japan.
Department of Plastic and Reconstructive Surgery Asahikawa Medical University Asahikawa Japan.
IJU Case Rep. 2025 Mar 26;8(3):227-230. doi: 10.1002/iju5.70012. eCollection 2025 May.
We present the case of a patient who achieved urinary continence after undergoing a gracilis muscle flap (GMF) for recanalization and fistula after bladder neck closure (BNC).
A male patient with neurogenic lower urinary tract dysfunction complained of difficulty inserting the catheter because of numerous false cavities in the prostatic urethra. We performed BNC to create a continent catheterizable stoma. However, the bladder neck was recanalized in the early postoperative period. Next, we dissected and closed the urethra transperineally. Due to the tiny fistula, the patient's urinary incontinence persisted. Finally, we dissected and closed the urethra again transperineally, and the closed area was covered with a GMF. Since then, the urethra has been completely closed, and urinary continence has been achieved.
The possibility of recanalization after BNC must be kept in mind. Interposition and covering of the GMF are useful techniques for urethral and perineal fistulas.
我们报告一例患者，该患者在因膀胱颈关闭（BNC）后再通和瘘管形成而接受股薄肌瓣（GMF）手术后实现了尿失禁。
一名患有神经源性下尿路功能障碍的男性患者因前列腺尿道存在大量假腔而抱怨导尿管插入困难。我们进行了膀胱颈关闭术以创建一个可控性造口。然而，术后早期膀胱颈再次再通。接下来，我们经会阴解剖并关闭尿道。由于存在微小瘘管，患者的尿失禁持续存在。最后，我们再次经会阴解剖并关闭尿道，并用股薄肌瓣覆盖关闭区域。从那时起，尿道已完全关闭，实现了尿失禁。
必须牢记膀胱颈关闭术后再通的可能性。股薄肌瓣的置入和覆盖是治疗尿道和会阴瘘的有用技术。
