Rectourethral fistula (RUF) is a divesting complication after prostate cancer treatment. The RUF incidence after radical prostatectomy is about 0.5% to 2%, [1,2]. Radiotherapy, criotherapy and high intensity focused ultrasound are other more severe causes [3,4].
Repair of RUF is a challenging surgical procedure. There are some possible approaches but transperineal is the most utilized.
In cases of complex fistulas interposition of muscle flaps between the rectum and urethra is highly recommended. Gracilis muscle transposition (GMT) is the preferred, due to excellent mobility and vascularization for perineal reconstruction [5,6]. Dissection of the gracilis muscle is done using one, 2 or 3 large incisions in the medial border of the thigh.
The aim of this report is present a new minimally invasive access to obtain a pediculate flap of gracilis muscle to interposition between bladder and rectum to treat RUF.
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