medigraphic.com
Organo Oficial de la Sociedad Mexicana de Urología

2023, Number 3

<< Back

Rev Mex Urol 2023; 83 (3)

Complex urinary fistulas in children: repair with gracilis muscle flap interposition

Gómez-Sánchez A, Cabezalí-Barbacho D, Tordable-Ojeda CP, Herrero-López L, Gómez-Fraile A

Language: Spanish
References: 13
Page: 1-7
PDF size: 154.51 Kb.


ABSTRACT

Case description: Two complex urinary fistulas were repaired in two pediatric patients using gracilis muscle flap interposition. A 12 year-old girl with cloacal exstrophy and urethral fistula secondary to a cervicourethral disconnection, and a 12 year-old boy with previous vesicoprostatic rhabdomyosarcoma and rectourethral fistula.
Relevance: Gracilis muscle flap interposition is frequently used in adults to repair urinary fistulas, with a success of 70-90%. In pediatric patients, there is limited literature reporting results of this technique.
Clinical implications: We consider that the use of gracilis muscle flap to repair urinary fistulas in children is feasible, being a safe technique with good short-term results.
Conclusions: Gracilis muscle flap interposition should be considered as a surgical option in the treatment of complex urinary fistulas in children.


REFERENCES

  1. Huang X, Tan SS, Chen Y, Li T. AcquiredRectourethral and Rectovaginal Fistulas inChildren: A Systematic Review. Frontiers inPediatrics. 2021;9. https://doi.org/10.3389/fped.2021.657251

  2. Cerdán Santacruz C, Cerdán Miguel J. Fístulasrecto-uretrales adquiridas: etiopatogenia,diagnóstico y opciones terapéuticas. CirugíaEspañola. 2015 Mar;93(3):137–46. doi: https://doi.org/10.1016/j.ciresp.2014.10.005

  3. Ulrich D, Roos J, Jakse G, Pallua N. Gracilismuscle interposition for the treatment ofrecto-urethral and rectovaginal fistulas: aretrospective analysis of 35 cases. Journalof Plastic, Reconstructive & AestheticSurgery. 2009;62(3):352–6. doi: https://doi.org/10.1016/j.bjps.2008.11.067

  4. Muñoz-Duyos A, Navarro-Luna A, Pardo-Aranda F, Caballero JM, Borrat P, MaristanyC, et al. Gracilis Muscle Interposition forRectourethral Fistula After LaparoscopicProstatectomy: A Prospective Evaluation andLong-term Follow-up. Diseases of the Colon &Rectum. 2017;60(4):393–8. doi: https://doi.org/10.1097/dcr.0000000000000763

  5. Zmora O, Tulchinsky H, Gur E, GoldmanG, Klausner JM, Rabau M. Gracilis MuscleTransposition for Fistulas Between the Rectumand Urethra or Vagina. Diseases of the Colon &Rectum. 2006;49(9):1316–21. doi: https://doi.org/10.1007/s10350-006-0585-3

  6. Hechenbleikner EM, Buckley JC, Wick EC.Acquired Rectourethral Fistulas in Adults:A Systematic Review of Surgical RepairTechniques and Outcomes. Diseases of the Colon& Rectum. 2013;56(3):374–83. doi: https://doi.org/10.1097/dcr.0b013e318274dc87

  7. Ghoniem G, Elmissiry M, Weiss E, LangfordC, Abdelwahab H, Wexner S. TransperinealRepair of Complex Rectourethral Fistula UsingGracilis Muscle Flap Interposition—Can Urinaryand Bowel Functions be Preserved? Journal ofUrology. 2008;179(5):1882–6. doi: https://doi.org/10.1016/j.juro.2008.01.021

  8. González-Contreras QH, Bahena-AponteJA, Salinas-Aragón E, Jiménez-GonzálezA, González-Longoria G. Interposición demúsculo grácil para reparar fístula rectouretral.Informe de un caso. Cir Cir. 2011;79(4):371–3.

  9. Zmora O, Potenti FM, Wexner SD, PikarskyAJ, Efron JE, Nogueras JJ, et al. Gracilis muscletransposition for iatrogenic rectourethral fistula.Ann Surg. 2003;237(4):483–7. doi: https://doi.org/10.1097/01.sla.0000059970.82125.db

  10. Takano S, Boutros M, Wexner SD. GracilisMuscle Transposition for Complex PerinealFistulas and Sinuses: A Systematic LiteratureReview of Surgical Outcomes. Journalof the American College of Surgeons.2014;219(2):313–23. doi: https://doi.org/10.1016/j.jamcollsurg.2014.04.006

  11. Nerli RB, Koura A, Prabha V, Patne P, DevarajuS, Amarkhed SS, et al. Acquired recto-urethralfistula in children: Long-term follow-up. Journalof Pediatric Urology. 2009;5(6):485–9. doi:https://doi.org/10.1016/j.jpurol.2009.03.001

  12. Liu G-C, Xia H-M, Wen Y-Q, Zhang L-Y, LiZ-M. Considerations before repair of acquiredrectourethral and urethrovaginal fistulas inchildren. World J Pediatr. 2008;4(1):53–7. doi:https://doi.org/10.1007/s12519-008-0011-0

  13. Nikolaev VV. Recurrent rectourethralfistula repair: A novel technique of gracilismuscle interposition. Journal of PediatricSurgery. 2020;55(9):1974–8. doi: https://doi.org/10.1016/j.jpedsurg.2020.05.028




2020     |     www.medigraphic.com