Urethral functional reconstruction using a pedicled thigh flap for urethral cutaneous fistula after vulvar necrotizing fasciitis

The penile and scrotal skin are often resected after vulvar necrotizing fasciitis, so functional and aesthetic vulvar reconstruction is extremely challenging. With widespread and deepened infections, urethral fistulas can develop, forcing penis and scrotal amputations. In cases complicated with a urethral fistula, the wound cannot be treated by simple skin graft surgery, and complicated flap surgery is required. We verified that urethral functional reconstruction using a pedicled thigh flap is a useful technique for managing urethral cutaneous fistulas that develop after necrotizing fasciitis.