case_images: PMC5310386_01
case_images: Cystouethroscopy showing urethral defect.
case_images: f1000research-5-11661-g0000.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0000.jpg
case_images: f1
case_images: Repeat cystoscopy after 3 months showed persistent fistula ( Figure 1).
case_images: Perineal incision above anus.
case_images: f1000research-5-11661-g0001.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0001.jpg
case_images: f2
case_images: An inverted smiling incision was made in the perineum above the anus ( Figure 2).
case_images: Rectal wall defect at the level of fistula.
case_images: f1000research-5-11661-g0002.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0002.jpg
case_images: f3
case_images: The fistula was at the 1 o' clock position between the prostatic urethra and rectum ( Figure 3).
case_images: Suture line of rectal wall defect repair.
case_images: f1000research-5-11661-g0003.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0003.jpg
case_images: f4
case_images: The rectal defect was repaired in transverse fashion in a single layer with monocryl 2-0 sutures ( Figure 4).
case_images: Buccal mucosal graft (BMG) with anchoring sutures.
case_images: f1000research-5-11661-g0004.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0004.jpg
case_images: f5
case_images: BMG was harvested and positioned to bridge the urethral defect; it was anchored with interrupted 3-0 monofilament sutures ( Figure 5).
case_images: Gracilis muscle flap rotated to perineum.
case_images: f1000research-5-11661-g0005.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0005.jpg
case_images: f6
case_images: The gracilis muscle flap was harvested, rotated towards the perineum ( Figure 6) and interposed between the rectal and urethal repair ( Figure 7).
case_images: Gracilis muscle flap interposed and fixed between rectal and urethal repair.
case_images: f1000research-5-11661-g0006.jpg
case_images: PMC5310386_01_f1000research-5-11661-g0006.jpg
case_images: f7
case_images: The gracilis muscle flap was harvested, rotated towards the perineum ( Figure 6) and interposed between the rectal and urethal repair ( Figure 7).