Acquired Recto-Uretral Fistulas: Etiopathogenesis, Diagnosis and Therapeutic Options

A Curious Case of Rectal Ejaculation

“…A definitive gold-standard modality of diagnosis is not well established even though many cases are diagnosed by clinical suspicion followed by direct visualization by rectoscopy or cystourethroscopy [ 5 , 6 ]. Other imaging modalities such as CT, magnetic resonance imaging, and cystourethrography have also been used; however, subsequent direct visualization of the fistula typically occurs [ 6 ].…”

“…Conservative resolution by urinary or fecal diversion is variable ranging from 14% to 54% [ 5 ]. Due to the overall effect on the quality of life, and because most cases require surgical intervention for definitive therapy, conservative management is generally reserved for patients who are poor surgical candidates or who prefer a trial of less invasive management [ 5 , 34 , 36 ]. More complex cases may require surgical repair and postsurgical urinary or fecal diversion to facilitate optimal healing, as was the case in our patient [ 6 , 8 ].…”

“…Acquired RUFs occur due to surgery, radiation, trauma, and inflammatory states such as Crohn’s disease [ 2 ]. Most cases are related to prostate cancer or caused by prostate cancer therapy [ 5 ]. Presenting symptoms typically manifest as pneumaturia, fecaluria, hematuria, and urinary tract infections [ 5 , 6 ].…”

“…Most cases are related to prostate cancer or caused by prostate cancer therapy [ 5 ]. Presenting symptoms typically manifest as pneumaturia, fecaluria, hematuria, and urinary tract infections [ 5 , 6 ]. Management of these fistulous connections is complex and typically requires surgical correction with varying surgical techniques depending on the underlying etiology and surgeon preference [ 2 , 5 ].…”

“…Presenting symptoms typically manifest as pneumaturia, fecaluria, hematuria, and urinary tract infections [ 5 , 6 ]. Management of these fistulous connections is complex and typically requires surgical correction with varying surgical techniques depending on the underlying etiology and surgeon preference [ 2 , 5 ]. Here, we describe a case of RUF causing the rectal passage of sperm due to traumatic Foley catheter insertion.…”