Traditional methods of reconstructing full-thickness urethral defects
have employed a cutaneous component utilized to replace the lining of
the urethra. These methods have failed to take advantage of the regene
rative ability of urethral epithelium. This epithelium is capable of r
egenerating, eliminating the need for urethral lining reconstruction.
Muscle flap reconstruction provides an environment that allows for com
plete regeneration of the urethral epithelium. A 56-year-old male pres
ented with a 12-cm defect of the bulbous and penile urethra involving
180 degrees of the urethral circumference secondary to Fournier's gang
rene, A proximally pedicled gracilis muscle was used to reconstruct th
e urethral defect, This healed without stricture or leak, Urethral bio
psies showed satisfactory migration of the uroepithelium across the ur
ethral defect.