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Case Reports in Urology
Volume 2015, Article ID 836454, 3 pages
Case Report

Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique

1Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
2Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA

Received 12 July 2015; Accepted 13 September 2015

Academic Editor: Apul Goel

Copyright © 2015 Valary T. Raup et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Rectourinary fistulae and urinary-cutaneous fistulae are a rare yet devastating complication. Current options for tissue interposition include rectus, gracilis, or gluteal muscle, omentum, or intestine for use in coloanal pull-through procedures. In elderly patients, testicular interposition flaps may be an excellent tissue option to use when vitalized tissue is necessary to supplement fistula repair. Elderly patients frequently have increased spermatic cord length, potentially offering a longer flap reach than use of a muscle flap. Additionally, mobilizing one of the testicles and developing it through the external inguinal ring may be a less morbid and less costly procedure than harvesting and tunneling a muscle flap. Longer follow-up and further studies are needed to determine the outcomes of this novel technique.