Journal des essais cliniques
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Choice of Urethral Reconstruction Methods Following Necrotizing Fasciitis and Urethral Defects in the Scrotal Region

Duan Liujian, Cao Jianwei, Le Wei, Zhang Lin, Cui Xingang*, Li Chao*

Objective: This study aimed to investigate the diagnosis, treatment, and selection of second-stage urethral reconstruction methods for necrotizing fasciitis and urethral defects in the scrotal region.

Methods: A retrospective analysis was conducted of a case of necrotizing fasciitis and urethral defects in the scrotal region treated by the author. The clinical and pathological characteristics, treatment process, surgical methods, outcomes of second-stage urethral reconstruction, and relevant literature were summarized.

Results: A patient with necrotizing fasciitis and urethral defects in the scrotal region underwent bladder diversion, surgical debridement, vacuum-sealing drainage, and wound closure. Four weeks after the wound healed, the patient was discharged for recuperation. Six months later, scrotal urethral reconstruction was performed using a circular penile skin flap graft to repair the 12 cm urethral defect. The urethral catheter was removed after three weeks, resulting in unobstructed urination and satisfactory recovery.

Conclusion: Clinical cases of necrotizing fasciitis and complete urethral defects in the scrotal region are rare. In the first stage, diverting urine flow and completely removing necrotic tissue while controlling the infection are crucial. After wound healing, the selection of an appropriate method for second-stage urethral reconstruction can achieve favorable outcomes.