Abstract
Rationale:Periurethral abscess is a life-threatening disease, and the occurrence of a urethral defect with periurethral abscess is a rare finding. In this case, the patient had a lengthy urethral defect from the bulbous urethra to the membranous urethra accompanied by periurethral abscess that developed within a short time. Herein, we report a case of a pedicle-sparing tunica vaginalis flap utilized in urethral reconstruction which degenerated due to fibrotic changes and soft tissue defects in the urethral bed.Patient concerns:The patient was a 36-year-old man with fever and lower urinary tract symptoms who had been treated with antibiotics and anti-inflammatory drugs for urinary tract infections 3 days before admission. Purulent necrosis was formed by the urethral abscess, and a long-length urethral defect was formed in the bulbous urethra.Diagnosis:Based on the initial computed tomography and laboratory findings, empirical antibiotics were administered to treat a lower urinary tract infection. On the 7th day of hospitalization, ultrasonography was performed due to the sudden swelling of the scrotum, and the patient was diagnosed with a periurethral abscess that was 10 × 3 cm in size.Intervention:Initial urinary diversion, wide debridement, and a large amount of abscess drainage were performed. Necrosis of the urethral ventral part caused a urethral defect that was 5 cm in size. After treatment with antibiotics, long-term disinfection and intermittent debridement were conducted and urethral reconstruction was performed using a tunica vaginalis flap with preserved vascular structure.Outcomes:No complications occurred until 6 months after urethral reconstruction.Lessons:Urethral reconstruction using a tunica vaginalis flap is a good method for selected patients. Pedicle-sparing tunica vaginalis is an advantageous material for resolving urethral defects, especially when the surrounding circulation conditions are poor.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.