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[Urethral lesion associated with perineal tissue defect: immediate combined repair with a musculocutaneous flap from the m. gracilis].

Facing urethro-perineal lesions with large soft tissue defects, the surgeon has to set himself a fourfold target. First, the urethral lesion has to be repaired, and second it needs immediate protection. Third, the tissue defect needs to be filled up, and forth the skin should be closed. A double team surgery, combining the urethral repair and its immediate covering by a gracilis musculo-cutaneous flap, has given functional and morphological results. The highly vascularized muscular portion of the flap prevents local infection and warrants good wound healing in an ischemic region. Its bulk may fill the perineal defect and protect a delicate urethroplasty. With the growing collaboration between urologic and plastic surgeons, this technique will probably find wider indications, possibly when dealing with important perineal trauma.