A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure

Introduction

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).

Case Presentation

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.

Conclusion

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.