{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:08:17Z","timestamp":1773180497605,"version":"3.50.1"},"reference-count":10,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,12]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>Urethrocutaneous fistula (UCF) poses a challenge to the reconstructive urologist in terms of its location, patient\u2019s expectations, availability of tissues for interposition, wound infection and chances of recurrence. Also, patient-related factors, such as uncontrolled diabetes, local surgery with extensive tissue loss, prior history of radiation, poor nutritional status and presence of any distal obstruction in the urethra severely affect the outcomes of a good repair with vascularised flap. We report two cases of UCF repair in adults using scrotal and gracilis muscle flaps (GMFs), their anatomic basis, technicality and advantages. The scrotal flap was used in the first case where it was freely available and GMF in second case where the patient had already undergone extensive local tissue debridement for Fournier\u2019s gangrene and hence, we had to look for a distant flap for protection of the UCF repair. Both patients had an uneventful recovery, there were no early or late treatment-related complications and follow-up after the third and sixth\u2009month of surgery revealed no recurrence and the patients are voiding well.<\/jats:p>","DOI":"10.1136\/bcr-2020-236475","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T12:49:17Z","timestamp":1618836557000},"page":"e236475","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Flaps in adult urethrocutaneous fistula repair: a report of two cases with the review of literature"],"prefix":"10.1136","volume":"14","author":[{"given":"Sri Harsha","family":"Bokka","sequence":"first","affiliation":[{"name":"Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sreerag","family":"Kodakkattil Sreenivasan","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5583-5713","authenticated-orcid":false,"given":"Ketan","family":"Mehra","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friji","family":"Meethale Thiruvoth","sequence":"additional","affiliation":[{"name":"Plastic Surgery, JIPMER, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"2025082710320938000_14.4.e236475.1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.5999\/aps.2013.40.5.584","article-title":"Vascularisation of urethral repairs with the gracilis muscle flap","volume":"40","author":"Kua","year":"2013","journal-title":"Arch Plast Surg"},{"key":"2025082710320938000_14.4.e236475.2","doi-asserted-by":"crossref","first-page":"828","DOI":"10.5489\/cuaj.1983","article-title":"Three-Layer reconstruction of large urethrocutaneous fistulas using scrotal-septal flaps","volume":"8","author":"Zhou","year":"2014","journal-title":"Can Urol Assoc J"},{"key":"2025082710320938000_14.4.e236475.3","doi-asserted-by":"crossref","first-page":"96","DOI":"10.5213\/inj.2012.16.2.96","article-title":"Perineum-based Pediculated scrotal flap for reconstructive urethral surgery","volume":"16","author":"Jeong","year":"2012","journal-title":"Int Neurourol J"},{"key":"2025082710320938000_14.4.e236475.4","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199705000-00026"},{"key":"2025082710320938000_14.4.e236475.5","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-017-2798-z","article-title":"Urethral calculi with a urethral fistula: a case report and review of the literature","volume":"10","author":"Zeng","year":"2017","journal-title":"BMC Res Notes"},{"key":"2025082710320938000_14.4.e236475.6","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/j.1442-2042.2005.01050.x","article-title":"Isolated congenital urethrocutaneous fistula","volume":"12","author":"Akman","year":"2005","journal-title":"Int J Urol"},{"key":"2025082710320938000_14.4.e236475.7","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/00006534-198066030-00017","article-title":"Fistulas of the penile urethra","volume":"66","author":"Horton","year":"1980","journal-title":"Plast Reconstr Surg"},{"key":"2025082710320938000_14.4.e236475.8","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/j.1464-410X.2008.08167.x","article-title":"Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps","volume":"103","author":"Carrera","year":"2009","journal-title":"BJU Int"},{"key":"2025082710320938000_14.4.e236475.9","article-title":"Reconstruction of defects after Fournier gangrene: a systematic review","volume":"15","author":"Karian","year":"2015","journal-title":"Eplasty"},{"key":"2025082710320938000_14.4.e236475.10","doi-asserted-by":"publisher","DOI":"10.1007\/BF01627695"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-236475","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:32:21Z","timestamp":1756315941000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-236475"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,19]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bcr-2020-236475"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-236475","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}