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      Dartos Fascia Interposition Flap for Penetrating Cavernosal and Urethral Trauma

      case-report

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          Abstract

          We present an unusual case of a single gunshot to the genitalia in which the bullet trajectory injured the urethra, corpus cavernosum, and both testicles. All injuries were successfully repaired during initial exploration. Our report serves as a reminder to clinicians to have a high index of suspicion in this circumstance and consider immediate exploration of all the injured areas. We also demonstrate the use of a dartos fascia interposition flap to cover and separate the concomitant urethral and corporal sutures lines. Our dartos flap bolstered the urethral and cavernosal repairs and helped prevent postoperative corporourethral fistula formation.

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          Most cited references5

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          Anterior urethral injuries: four years of experience at the Detroit General Hospital.

          Among 19 patients with trauma of the anterior urethra 16 were treated by urinary diversion without primary repair of the injured area. Of these patients 15 recovered with excellent results. Since most traumatic injuries to the anterior urethra are partial disruptions we believe that urinary diversion may be the only treatment needed.
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            Evaluation and management of gunshot wounds of the penis: 20-year experience at an urban trauma center.

            Although gunshot injuries to the penis occur relatively infrequently in patients with penetrating trauma, they often present dilemmas of subsequent evaluation and management. We review our extensive experience with gunshot wounds to the penis at a high volume urban trauma center.
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              Controversies in the management of male external genitourinary trauma.

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                Author and article information

                Contributors
                Journal
                Urol Case Rep
                Urol Case Rep
                Urology Case Reports
                Elsevier
                2214-4420
                01 December 2016
                January 2017
                01 December 2016
                : 10
                : 36-37
                Affiliations
                [a ]Division of Urology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103, USA
                [b ]Division of Urology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, USA
                [c ]Division of Trauma, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, USA
                Author notes
                []Corresponding author. Fax: +1 856 365 7582. yang-hailiu@ 123456cooperhealth.edu
                Article
                S2214-4420(16)30207-8
                10.1016/j.eucr.2016.11.015
                5137170
                25d91886-179d-4e40-bd9c-0cc7ff330e6e
                © 2016 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 30 October 2016
                : 10 November 2016
                Categories
                Trauma and Reconstruction

                dartos interposition flap,penetrating penile injury,gunshot wound,penetrating urethral injury

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