Penile Flaps for Bulbar Urethral Necrosis

Pelvic fracture urethral injury (PFUI) occurs in 10% of those who suffer from pelvic fractures [1]. Anastomotic urethroplasty remains the gold standard of treatment for PFUI. Progressive perineal approach is the preferred surgical method, though when required, a transabdominal approach can be utilized. Bulbar urethral ischemic necrosis (BUIN) is an iatrogenic entity, which results from previously failed PFUI repairs. In the past, this entity was referred to as “long gap” or “unsalvageable” after previous failed repairs [2, 3]. Turner-Warwick defined spongionecrosis of the bulbar urethra in 1986 [4].