Reconstruction of Pubic Defects Using Bilateral Advancement Flap in Bladder Exstrophy: A Case Report

J Korean Wound Management Soc > Volume 8(2); 2012 > Article

Clinical Report

Journal of the Korean Wound Management Society 2012;8(2): 84-86.

방광 외번증 환자에게 양측 V-Y 전진 피판술을 이용한 음부재건 치험예

김소영ㆍ임소영

성균관대학교 의과대학 삼성서울병원 성형외과학교실

Reconstruction of Pubic Defects Using Bilateral Advancement Flap in Bladder Exstrophy: A Case Report

So Young Kim, So Young Lim

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Published online: 30 November 2012.

ABSTRACT

Reconstruction of pubic skin defects after bladder exstrophy correction is a challenging problem in respect to aesthetic considerations. The pubic area has a sufficient subcutaneous vascular network from internal and external pudendal arteries and V-Y advancement flap with subcutaneous pedicle can be used safely in the perineal area reconstruction. In this article, we report our experience of the pubic defect reconstruction using V-Y advancement island flap in adult patients bladder exstrophy. 24 years old female patient from Cambodia presented incomplete type of the bladder exstrophy. She had suffered from urinary frequency and incontinence after birth and presented external genitalia deformity. Thus, the reconstruction surgery was planned following the bladder exstrophy correction and perineoplasty performed by Urology surgical team. After the perineoplasty was performed, 15×3 cm soft tissue defect of pubic area was accompanied in the crescent shape bilaterally. We designed bilateral V-Y advancement flap from bilateral inguinal area, with the consideration that scars could be hidden in inguinal crease. The pubic defects could be covered successfully and clitoroplasty was conducted additionally. After the surgery, hospital course was good and there is no immediate postoperative complication. Satisfaction with the postoperative result was very high. The subcutaneous pedicled V-Y advancement flap can be one of the reliable options for the reconstruction of pubic defects after perineoplasty in the bladder exstrophy patients, in the point of not only successful coverage of defects, but also aesthetically satisfactory outcome. (J Korean Wound Management Soc 2012;8:84-86)

Key Words: Bladder exstrophy, Bilateral V-Y advancement flap