Urinary bladder reconstruction using a free revascularized musculo-cutaneous thoracodorsal autograft. A case report

• Published in: Urologii͡a︡ (Moscow, Russia : 1999) no. 3; p. 134
• Main Authors: Glybochko, P V, Reshetov, I V, Rapoport, L M, Istranov, A L, Sukhanov, R B, Gogokhiya, M R, Shchedrina, M A, Adamyan, R T
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 01.07.2018
• Subjects: Accidents, Traffic; Adult; Humans; Male; Myocutaneous Flap - blood supply; Myocutaneous Flap - transplantation; Reconstructive Surgical Procedures - methods; Surgical Flaps - blood supply; Surgical Flaps - transplantation; Treatment Outcome; Urinary Bladder - injuries; Urinary Bladder - surgery; Urologic Surgical Procedures - methods; reconstruction; microsurgery; bladder; thoracodorsal autograft; urinary diversion
• ISSN: 1728-2985
• DOI: 10.18565/urology.2018.3.134-140

The article presents a rare case of urinary bladder reconstruction using thoracodorsal revascularized autograft in a patient with a bladder injury resulting from a road traffic accident. The area and size of the thoracodorsal flap (2215 cm) were determined using a 500 ml latex model of the bladder. The autograft was revascularized through external iliac vessels. From the thoracodorsal autograft, the dome was formed with the dermal part inward, which was fixed along its circumference to the bladder edges with 3/0 prolene sutures. The muscular part of the thoracodorsal flap was fixed along the perimeter to the remaining aponeurosis and covered by a free expanded cutaneous autograft. The surgery resulted in a newly constructed neobladder of sufficient volume (250-300 ml) with elements of the patients own bladder (posterior wall and neck) while sparing the patient from a cystostomy and improving his quality of life.