Free Ileal Flap: An Alternative Approach to Urethral Reconstruction

The scarred urethra remains a difficult reconstructive problem. Patients who have undergone multiple attempts at reconstruction lack the local tissue necessary for successful management using traditional techniques. In this report, we present two cases of urethral reconstruction performed at our institution with free ileal flaps. Both patients suffered from chronically strictured urethra, having failure multiple prior operative interventions. A joint plastic and genitourinary reconstructive surgical team excised all scarred native urethra, harvesting and inserted an ileal free flap for successful urethral substitution. Postoperatively, both intestinal neourethras remain patent. We offer this technique as a promising alternative solution to the reconstructive challenge.