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

ABSTRACT 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 difficu...

Full description

Saved in:
Bibliographic Details
Main Authors: Naoki Wada, Haruka Takagi, Taichiro Ishimaru, Daiki Kikuchi, Miyu Ohtani, Hidehiro Kakizaki, Takeshi Yamao, Toshihiko Hayashi
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:IJU Case Reports
Subjects:
Online Access:https://doi.org/10.1002/iju5.70012
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850191761944608768
author Naoki Wada
Haruka Takagi
Taichiro Ishimaru
Daiki Kikuchi
Miyu Ohtani
Hidehiro Kakizaki
Takeshi Yamao
Toshihiko Hayashi
author_facet Naoki Wada
Haruka Takagi
Taichiro Ishimaru
Daiki Kikuchi
Miyu Ohtani
Hidehiro Kakizaki
Takeshi Yamao
Toshihiko Hayashi
author_sort Naoki Wada
collection DOAJ
description ABSTRACT 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.
format Article
id doaj-art-3dcaf6093637448c9607874a9993dc42
institution OA Journals
issn 2577-171X
language English
publishDate 2025-05-01
publisher Wiley
record_format Article
series IJU Case Reports
spelling doaj-art-3dcaf6093637448c9607874a9993dc422025-08-20T02:14:49ZengWileyIJU Case Reports2577-171X2025-05-018322723010.1002/iju5.70012A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck ClosureNaoki Wada0Haruka Takagi1Taichiro Ishimaru2Daiki Kikuchi3Miyu Ohtani4Hidehiro Kakizaki5Takeshi Yamao6Toshihiko Hayashi7Department of Renal and Urologic Surgery Asahikawa Medical University Asahikawa JapanDepartment of Renal and Urologic Surgery Asahikawa Medical University Asahikawa JapanDepartment of Renal and Urologic Surgery Asahikawa Medical University Asahikawa JapanDepartment of Renal and Urologic Surgery Asahikawa Medical University Asahikawa JapanDepartment of Renal and Urologic Surgery Asahikawa Medical University Asahikawa JapanDepartment of Renal and Urologic Surgery Asahikawa Medical University Asahikawa JapanDepartment of Plastic and Reconstructive Surgery Asahikawa Medical University Asahikawa JapanDepartment of Plastic and Reconstructive Surgery Asahikawa Medical University Asahikawa JapanABSTRACT 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.https://doi.org/10.1002/iju5.70012bladder neck closuregracilis muscle flapspina bifidaurinary continence
spellingShingle Naoki Wada
Haruka Takagi
Taichiro Ishimaru
Daiki Kikuchi
Miyu Ohtani
Hidehiro Kakizaki
Takeshi Yamao
Toshihiko Hayashi
A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure
IJU Case Reports
bladder neck closure
gracilis muscle flap
spina bifida
urinary continence
title A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure
title_full A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure
title_fullStr A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure
title_full_unstemmed A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure
title_short A Case of Achieving Urinary Continence Using Gracilis Muscle Flap for Recanalization and Fistula After Bladder Neck Closure
title_sort case of achieving urinary continence using gracilis muscle flap for recanalization and fistula after bladder neck closure
topic bladder neck closure
gracilis muscle flap
spina bifida
urinary continence
url https://doi.org/10.1002/iju5.70012
work_keys_str_mv AT naokiwada acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT harukatakagi acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT taichiroishimaru acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT daikikikuchi acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT miyuohtani acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT hidehirokakizaki acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT takeshiyamao acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT toshihikohayashi acaseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT naokiwada caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT harukatakagi caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT taichiroishimaru caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT daikikikuchi caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT miyuohtani caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT hidehirokakizaki caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT takeshiyamao caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure
AT toshihikohayashi caseofachievingurinarycontinenceusinggracilismuscleflapforrecanalizationandfistulaafterbladderneckclosure