A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes
**Introduction**: Perineal urethrostomy is a valuable technique in the management of complex anterior urethral strictures, as well as following penectomy or urethrectomy. Traditional techniques that employ perineal or scrotal skin flaps have documented failure rates of up to 30 per cent. Current tec...
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| Format: | Article |
| Language: | English |
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Australian Society of Plastic Surgeons
2018-03-01
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| Series: | Australasian Journal of Plastic Surgery |
| Online Access: | https://doi.org/10.34239/ajops.v1i1.17 |
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| _version_ | 1849691883232559104 |
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| author | Daniel J Reilly Eric K Sham Justin BL Chee Ajay Chauhan |
| author_facet | Daniel J Reilly Eric K Sham Justin BL Chee Ajay Chauhan |
| author_sort | Daniel J Reilly |
| collection | DOAJ |
| description | **Introduction**: Perineal urethrostomy is a valuable technique in the management of complex anterior urethral strictures, as well as following penectomy or urethrectomy. Traditional techniques that employ perineal or scrotal skin flaps have documented failure rates of up to 30 per cent. Current techniques for salvage have only modest success, leaving patients few options other than permanent suprapubic catheter or cystectomy and ileal conduit formation.
**Results**: We present a new method of perineal urethrostomy using perforator-based lotus petal flaps in cases which were high risk or unsuitable for traditional perineal urethrostomy techniques, or where traditional strategies had failed. All patients demonstrated continent voiding at a minimum of 22 months follow-up, with patency confirmed by flexible cystoscopy. No complications were encountered.
**Conclusion**: Utilisation of lotus petal flaps in high-risk cases of perineal urethrostomy will lead to significant improvements in patient outcomes. The availability of larger amounts of soft tissue coverage will obviate the need for compromise on either resection of involved urethra, or calibre and inset of urethrostomy. This will subsequently minimise the rates of failure, reduce the requirement for urinary diversion procedures and lead to improved quality of life. |
| format | Article |
| id | doaj-art-b2adbbc1581e405390b3bb20e124af48 |
| institution | DOAJ |
| issn | 2209-170X |
| language | English |
| publishDate | 2018-03-01 |
| publisher | Australian Society of Plastic Surgeons |
| record_format | Article |
| series | Australasian Journal of Plastic Surgery |
| spelling | doaj-art-b2adbbc1581e405390b3bb20e124af482025-08-20T03:20:54ZengAustralian Society of Plastic SurgeonsAustralasian Journal of Plastic Surgery2209-170X2018-03-011110.34239/ajops.v1i1.17A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomesDaniel J ReillyEric K ShamJustin BL CheeAjay Chauhan**Introduction**: Perineal urethrostomy is a valuable technique in the management of complex anterior urethral strictures, as well as following penectomy or urethrectomy. Traditional techniques that employ perineal or scrotal skin flaps have documented failure rates of up to 30 per cent. Current techniques for salvage have only modest success, leaving patients few options other than permanent suprapubic catheter or cystectomy and ileal conduit formation. **Results**: We present a new method of perineal urethrostomy using perforator-based lotus petal flaps in cases which were high risk or unsuitable for traditional perineal urethrostomy techniques, or where traditional strategies had failed. All patients demonstrated continent voiding at a minimum of 22 months follow-up, with patency confirmed by flexible cystoscopy. No complications were encountered. **Conclusion**: Utilisation of lotus petal flaps in high-risk cases of perineal urethrostomy will lead to significant improvements in patient outcomes. The availability of larger amounts of soft tissue coverage will obviate the need for compromise on either resection of involved urethra, or calibre and inset of urethrostomy. This will subsequently minimise the rates of failure, reduce the requirement for urinary diversion procedures and lead to improved quality of life.https://doi.org/10.34239/ajops.v1i1.17 |
| spellingShingle | Daniel J Reilly Eric K Sham Justin BL Chee Ajay Chauhan A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes Australasian Journal of Plastic Surgery |
| title | A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes |
| title_full | A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes |
| title_fullStr | A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes |
| title_full_unstemmed | A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes |
| title_short | A novel application of the lotus petal flap in high-risk perineal urethrostomy: principles and outcomes |
| title_sort | novel application of the lotus petal flap in high risk perineal urethrostomy principles and outcomes |
| url | https://doi.org/10.34239/ajops.v1i1.17 |
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