Rectourethral fistula following laparoscopic radical prostatectomy

Chun, Linda; Abbas, Maher A.

doi:10.1007/s10151-011-0710-8

Cited by 19 publications

(13 citation statements)

References 23 publications

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“…Various conditions have been associated with RUF including urologic malignancy, pelvic trauma, inflammatory bowel disease, and chronic infection [1][2][3][4]. In the Western world, the most common etiology of RUF is prostate cancer treatment including radical prostatectomy and radiation therapy [5][6][7][8][9]. Reported rates of RUF after radical retropubic prostatectomy are less than 2 %, 0.2 % for brachytherapy, 2.9 % for combined external beam therapy and brachytherapy boost, and 0.4-1.2 % for cryotherapy or high-frequency ultrasound (HIFU) [8,[10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Algorithm-based multidisciplinary treatment approach for rectourethral fistula

Keller

Aboseif

Lesser

et al. 2015

Int J Colorectal Dis

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Section: Introductionmentioning

confidence: 99%

Algorithm-based multidisciplinary treatment approach for rectourethral fistula

Keller

Aboseif

Lesser

et al. 2015

Int J Colorectal Dis

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“…A rectal advancement flap has been used more frequently and is considered to be an effective procedure for treating anorectal or rectovaginal fistulae where the rectum is the high-pressure side [17, 18]. However, in RUF, because the urethra is the high-pressure side, the transanal approach should be limited to small, simple fistulae whereas a large fistula might require a more complex procedure [19]. …”

Section: Discussionmentioning

confidence: 99%

Rectourethral Fistula: Systemic Review of and Experiences With Various Surgical Treatment Methods

et al. 2014

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PurposeA rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation or trauma. Although various surgical procedures for the treatment of an RUF have been described, none has gained acceptance as the procedure of choice. The aim of this study was to review our experience with surgical management of RUF.MethodsThe outcomes of 6 male patients (mean age, 51 years) with an RUF who were operated on by a single surgeon between May 2005 and July 2012 were assessed.ResultsThe causes of the RUF were iatrogenic in four cases (two after radiation therapy for rectal cancer, one after brachytherapy for prostate cancer, and one after surgery for a bladder stone) and traumatic in two cases. Fecal diversion was the initial treatment in five patients. In one patient, fecal diversion was performed simultaneously with definitive repair. Four patients underwent staged repair after a mean of 12 months. Rectal advancement flaps were done for simple, small fistula (n = 2), and flap interpositions (gracilis muscle flap, n = 2; omental flap, n = 1) were done for complex or recurrent fistulae. Urinary strictures and incontinence were observed in patients after gracilis muscle flap interposition, but they were resolved with simple treatments. The mean follow-up period was 28 months, and closure of the fistula was achieved in all five patients (100%) who underwent definitive repairs. The fistula persisted in one patient who refused further definitive surgery after receiving only a fecal diversion.ConclusionDepending on the severity and the recurrence status of RUF, a relatively simple rectal advancement flap repair or a more complex gracilis muscle or omental flap interposition can be used to achieve closure of the fistula.

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“…In patients with significant comorbidity, previous pelvic irradiation, previous failed attempts at closure or pelvic sepsis, urinary and faecal diversion before definitive surgical repair are generally accepted . This alone may result in closure, with reported rates of success in 60% of selected patients . Where the fistula is complex, for example if it has occurred following radiotherapy, some form of direct approach is likely to be needed because conservative treatment will probably not be successful.…”

Section: Discussionmentioning

confidence: 99%

Transperineal repair with bulbocavernosus muscle interposition for recto‐urethral fistula

Ganio¹,

Martina²,

Novelli³

et al. 2013

Colorectal Disease

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Aim The results of repair of recto-urethral fistulae (RUF) are presented using a bulbocavernosus muscle graft.Method Prospectively collected data were reviewed on 11 patients with RUF operated on between 2003 and 2011. Of these, six were treated by a bulbocavernosus flap. Two RUF had occurred after prostatectomy, three after prostatectomy and radiotherapy and one after perineal trauma; all had a urinary diversion.Results Closure of the fistula was achieved in all patients and was maintained for the duration of the period of follow up (mean AE SD = 43.5 AE 24.7 months; range, 8-80 months) There were no complications.Conclusion This new technique for the repair of RUF is safe and effective, especially in patients with complex postradiation RUF.

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Rectourethral fistula following laparoscopic radical prostatectomy

Abstract: Patients who develop a rectourethral fistula following laparoscopic radical prostatectomy often require additional operations for symptoms control and/or healing of the fistula. Urinary continence is affected in the majority of patients.

Cited by 19 publications

References 23 publications

Algorithm-based multidisciplinary treatment approach for rectourethral fistula

Algorithm-based multidisciplinary treatment approach for rectourethral fistula

Rectourethral Fistula: Systemic Review of and Experiences With Various Surgical Treatment Methods

Transperineal repair with bulbocavernosus muscle interposition for recto‐urethral fistula

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