Use of Omentum in Urethral Reconstruction

Summary

The omentum is a well-vascularized organ that can be utilized to maximize surgical success and promote wound healing in urethral reconstruction and fistula repair. Omentum can act as a bulking flap to fill the dead space, as a physical barrier between reactive tissues, as well as a vascular blood supply and lymphatic drain to support tenuous tissues and to help resolve infections and tissue inflammation. In one-third of cases the omentum is long enough to reach the pelvis, without any mobilization. In the other two-thirds of cases, methods in omental lengthening include dissecting the omentum off the transverse colon, dissecting the omentum off the stomach, and basing the blood supply on the right gastroepiploic artery.