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The aim of the work is to present a modern view on the clinical application of urogenital flaps, such as autologous scrotal flap and foreskin. This plastic material has such characteristics as acceptable extensibility, good blood supply, accessibility and the absence of significant defects in the donor area. The use of urogenital flaps is an actual and promising direction in reconstructive urology. Unfortunately, currently there is not much literature data on the efficiency of using this type of flaps. Recent literature, both national and foreign studies, dedicated to using urogenital flaps, including comparative data with flaps of other localizations, are reviewed in the article. The review consists of several parts, corresponding to certain groups of nosologies, for the treatment of which urogenital flaps of different localization were used.

Aim: The aim of this study was to determine the possibilities of volumetric dynamic voiding multispiral computed cystourethrography (VDMMCT) for assessment of the lower urinary tract during voiding., Materials and Methods: VDMMCT was performed in a series of 22 patients with various urethral pathologies using 320 detector rows (640 unique slices; row width 0,5 mm). This method allows to cover the scan area of 16 cm per one rotation of the X-ray tube. In all patients, the cross-sectional area of the various urethral parts was estimated and the urinary bladder volume and average urine flow rate during all voiding phases were calculated., Results: VDMMCT was performed for dynamic evaluation of bladder volumes changes and analyzing a passage of contrasted urine throughout the urethra. The average volume of the urinary bladder was 356.3+/-179.9 ml, while the voiding volume was 299.5+/-154.8 ml. The average pre- and postoperative urine flow rate was 4.1+/-1.1 ml/s and 7.9+/-5.1 ml/s, respectively. The maximum urine flow rate was 19 ml/s. The average urethral diameter according to the VDMMCT after urethroplasty was 7.6+/-2.1 mm. The minimum length of urethral strictures was 17 mm, while the maximum length was 32 mm., Conclusion: Our results demonstrate the efficiency of the VDMMCT for assessing of the urethra throughout its length. VDMMCT can multidimensionally and dynamically represent the change of the bladder volume and the urine flow rate.

The article presents a rare case of urinary bladder reconstruction using thoracodorsal revascularized autograft in a patient with a bladder injury resulting from a road traffic accident. The area and size of the thoracodorsal flap (2215 cm) were determined using a 500 ml latex model of the bladder. The autograft was revascularized through external iliac vessels. From the thoracodorsal autograft, the dome was formed with the dermal part inward, which was fixed along its circumference to the bladder edges with 3/0 prolene sutures. The muscular part of the thoracodorsal flap was fixed along the perimeter to the remaining aponeurosis and covered by a free expanded cutaneous autograft. The surgery resulted in a newly constructed neobladder of sufficient volume (250-300 ml) with elements of the patients own bladder (posterior wall and neck) while sparing the patient from a cystostomy and improving his quality of life.