Single-stage repair of urethral fistula by vascular island groin flap.

A new technique for the repair of a urethral fistula at the penoscrotal junction is presented. Under local anaesthesia we have successfully repaired six of these fistulae using a groin island pedicle flap. The urethra is repaired by mobilising the mucous lining around the fistula and closing it longitudinally, using absorbable 4/0 chromic catgut sutures. The groin island pedicle flap which is based on superficial circumflex iliac vessels is used to cover the repaired lining. The donor defect is closed primarily. In all six cases there was primary healing. This procedure is recommended for cases where the skin around the fistula is badly scarred or where previous attempts at closure have failed. Moderate defects of penile and scrotal skin can also be repaired by this type of flap.