Bilateral Puborectalis Interposition Repair of Rectourethral Fistula

Abstract

The double-breasted puborectalis interposition flap is an alternative transperineal procedure in the management of rectourethral fistula. It avoids a laparotomy and is rectum sparing.

Algorithm-based multidisciplinary treatment approach for rectourethral fistula

“…Few medical centers have gathered significant experience treating this condition, and most scientific reports on this topic have described case series or small retrospective reviews [4,18,20,23,32]. A wide variation in treatment recommendations have been often based on surgical preferences or familiarity with a particular surgical technique.…”

A New Technique to Repair Vesicorectal Fistula: Overlapping Rectal Muscle Plasty by Transanal Endoscopic Surgery

“…Although a variety of operative procedures has been introduced in the past, none of them has gained recognition as a standard method to date [4][5][6][7][8]. The transperineal approach is the most frequently performed operation, mainly because it reaches the fistula site easily and can facilitate the interposition of a muscle graft from the thigh [8,[14][15][16][17]. There have been reports on gracilis muscle interposition with favorable success rates, and this can be regarded as the most reliable operative procedure so far [18][19][20].…”

Rectourethral and Complex Fistulas: Evaluation and Management

“…Each muscle flap is stitched into place with absorbable suture; the wound is closed over a drain. All fistulas were healed at median 8 months' follow-up [22]. The smaller size of the available muscle limits this approach somewhat.…”