Reconstruction of Strictures of the Fossa Navicularis Using a Transverse Penile Skin Island Flap (Jordan Flap)

Repairs of the fossa navicularis can be challenging and are at risk of developing fistulae or glans dehiscence. Historically, reconstruction of the meatus and fossa navicularis included several vertical advanced island flaps, with poor functional and cosmetic results [1–4]. Those vertically oriented dartos pedicled island flaps were narrow and could not support the aggressive advancement required. It was not until the late 1980s that Jordan changed the paradigm of fossa navicularis reconstruction when he described his transverse-oriented, hence wider, dartos-based penile skin island flap [5]. In an effort to minimize complexity and aggressiveness, recent surgical innovations include the ventral inlay buccal mucosa graft urethroplasty described by Nikolavsky; however, especially in the setting of failures or poor candidates for buccal graft repairs, more traditional repairs remain relevant, particularly those that maintain the appearance of the glans [6–7]. An additional benefit of this repair, if the stricture extends more proximal than the fossa navicularis, is that it can be applicable by making the penile skin island longer. This repair is not intended for patients with a history of lichen sclerosus.