Gracilis Muscle Interposition for Rectourethral Fistula After Laparoscopic Prostatectomy: A Prospective Evaluation and Long-term Follow-up

Muñoz-Duyos, Arantxa; Navarro-Luna, Albert; Pardo-Aranda, Fernando; Caballero, Josep M.; Borrat, P.; Maristany, Carles; Pando, José Antonio Guerra; Veloso, E

doi:10.1097/dcr.0000000000000763

Cited by 13 publications

(5 citation statements)

References 23 publications

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“…The treatment of complex RVF places high technical demands on the surgeon, particularly because of the high rates of recurrence of such fistulas .…”

Section: Discussionmentioning

confidence: 99%

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Operative results, sexual function and quality of life after gracilis muscle transposition in complex rectovaginal fistulas

et al. 2019

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Aim Successful treatment of complex rectovaginal fistulas (RVFs) continues to be a surgical challenge. Interposition of well‐perfused tissue, such as gracilis muscle, is one treatment option. The aim of this study was to investigate the operative results, sexual function and quality of life after gracilis muscle transposition (GMT) in the authors’ own group of patients. Method The study included 19 women with RVF (mean age 48 years). The postoperative outcome was evaluated by a questionnaire and clinical examination. Results The postoperative follow‐up period was 7 months to 3.5 years (mean 23 months). GMT led to primary healing of RVF in 10 (53%) patients. Recurrences were observed in nine (47%) patients with RVF, in four (44%) of whom healing was achieved as a result of further interventions. Following GMT, two complications (abscess formation) requiring revision occurred. Although 42% of the patients reported certain limitations following muscle removal, GMT is a procedure that has a positive influence on the healing rate (74%), quality of life, continence and patient satisfaction. Conclusion GMT is a procedure that allows healing in the majority of patients with RVFs, and it should be considered especially in patients with recurrent fistulas, in whom a correlation between decreasing healing rates and the number of previous operations has been demonstrated.

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“…The treatment of complex RVF places high technical demands on the surgeon, particularly because of the high rates of recurrence of such fistulas .…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of complex RVF places high technical demands on the surgeon, particularly because of the high rates of recurrence of such fistulas [9,12]. With the inclusion of 19 patients, the present study is one of the five largest studies on RVF [ [6,[13][14][15]] (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Operative results, sexual function and quality of life after gracilis muscle transposition in complex rectovaginal fistulas

et al. 2019

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“…It is clear that patient selection leads to improved outcomes. In a series of nine patients with nonradiated RUF, all with a previous failed repair attempt, all were successfully managed with transperineal fistula division and gracilis interposition graft [28]. All but one had fecal continuity restored; none reported fecal dysfunction or difficulty walking related to the gracilis harvest.…”

Section: Outcomes Of Ruf Repairmentioning

confidence: 99%

Rectourethral and Complex Fistulas: Evaluation and Management

Rakinic

Perry

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Concepts• Rectourethral fistula (RUF) is an uncommon but potentially devastating condition which may significantly impact a patient's quality of life. • Treatment of prostate cancer is most common etiology.• Up to 45% of simple RUF may heal with fecal diversion alone. • Ultimate repair may be quite complex, involving a multispecialty team approach over the course of several procedures. • Surgical repair with interposition of well-vascularized tissue has good outcomes, though radiation confers higher risk for permanent fecal or urinary diversion.

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“…(3) Este músculo, situado en la parte medial del muslo y con un pedículo neurovascular muy proximal, es una fuente de tejido sano y bien vascularizado que puede rotarse fácilmente hacia el periné e interponerse en la zona reparada para prevenir la recurrencia de la fístula. (3,4) El objetivo de este informe es describir nuestra experiencia en la reparación de fístulas urinarias complejas en pacientes pediátricos mediante interposición del músculo gracillis.…”

Section: Introductionunclassified

Fístulas urinarias complejas en niños: reparación mediante interposición de músculo gracillis

Gómez-Sánchez,

Cabezalí-Barbacho,

Tordable-Ojeda

et al. 2023

Rev Mex Urol

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Descripción de los casos: Se presentan dos pacientes pediátricos en los que efectuó un colgajo de músculo gracillis para la reparación de una fístula urinaria compleja. Una niña de 12 años con extrofia cloacal y fistulización uretral secundaria a una desconexión cervicouretral, y un niño de 12 años con antecedente de rabdomiosarcoma vesicoprostático con una fístula rectouretral. Relevancia: La interposición de músculo gracillis se utiliza frecuentemente en adultos para reparar fístulas urinarias, con tasas de éxito del 70-90%. En pacientes pediátricos la experiencia reportada con esta técnica es escasa. Implicaciones clínicas: Consideramos que es factible el uso de músculo gracillis para reparar fístulas urinarias complejas en pacientes pediátricos, siendo una técnica segura y con buenos resultados a corto plazo. Conclusiones: La interposición del músculo gracillis es una técnica quirúrgica que debe considerarse en el tratamiento de fístulas urinarias complejas en niños.

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Gracilis Muscle Interposition for Rectourethral Fistula After Laparoscopic Prostatectomy: A Prospective Evaluation and Long-term Follow-up

Abstract: Simple repair with perineal gracilis muscle interposition is a safe and effective technique for the treatment of postoperative rectourethral fistulas after nonradiated prostate cancer surgery.

Cited by 13 publications

References 23 publications

Operative results, sexual function and quality of life after gracilis muscle transposition in complex rectovaginal fistulas

Operative results, sexual function and quality of life after gracilis muscle transposition in complex rectovaginal fistulas

Rectourethral and Complex Fistulas: Evaluation and Management

Fístulas urinarias complejas en niños: reparación mediante interposición de músculo gracillis

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