Rectourinary Fistula: Principles of Management and A Technique of Surgical Closure

Goodwin, Willard E.; Turner, Roderick D.; Winter, Chester C.

doi:10.1016/s0022-5347(17)66172-x

Cited by 107 publications

(40 citation statements)

References 6 publications

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“…usually visible and may be catheterized for further dem onstration [4], The radiologic study includes secretory urogram and retrograde urethrography. According to our experience, a dynamic voiding cystourethrography can also be helpful.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Rectourethral Fistulae

Trippitelli¹,

Barbagli²,

Lenzi³

et al. 1985

Eur Urol

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Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Rectourethral Fistulae

Trippitelli¹,

Barbagli²,

Lenzi³

et al. 1985

Eur Urol

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“…Spontaneous URF closure has been reported in the literature; [3][4][5] however, no URF closed spontaneously in our series, although we admit that possibility in small, uncomplicated URF resulting from surgery.…”

Section: Discussionmentioning

confidence: 47%

“…3,4 Therefore, failure of conservative treatment mandates surgical intervention. Several techniques have been employed for decades to treat URF, including transperineal, abdominoperineal, trans-ano-rectal Francisco E. Martins, MD 1,2 ; Natália M. Martins (Parks), posterior transsacral (Kraske), and variants; 1,[5][6][7][8] however, despite all these reported surgical possibilities, the single "best" procedure is still a topic of intense debate.…”

Section: Introductionmentioning

confidence: 99%

Management of iatrogenic urorectal fistulae in men with pelvic cancer

Martins¹,

Martins²,

Pinheiro³

et al. 2017

CUAJ

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Introduction: Urorectal fistula (URF) is a devastating complication of pelvic cancer treatments and a surgical challenge for the reconstructive surgeon. We report a series of male patients with URF resulting from pelvic cancer treatments, specifically prostate (PCa), bladder (BCa), and rectal cancer (RCa), and explore the differences and impact on outcomes between purely surgical and non-surgical treatment modalities. Methods: Between October 2008 and June 2015, 15 male patients, aged 59-78 years (mean 67), with URF induced by pelvic cancer treatments were identified in our institutions. Patients with a history of diverticulitis, inflammatory bowel disease, or other benign conditions were excluded. We reviewed the patients' medical records for symptoms, diagnostic tests performed, type and etiology of the fistula, type of surgical reconstruction, followup, and outcomes. Results: Fourteen patients underwent surgical reconstruction. One patient developed metastatic disease before URF repair and, therefore, was excluded from this study. Mean followup (FU) was 32.7 months (14-79). All patients received diverting colostomy and temporary urinary diversion. An exclusively transperineal approach was used in nine (64.3%) patients and a combined abdominoperineal in five (35.7%). Overall successful URF closure was achieved in 12 (85.7%) patients, nine (64.3%) of whom at the first reconstructive attempt, two (14.3%) after two attempts (in our institution), and one (7.1%) after three attempts (two of which elsewhere). An interposition flap was used in seven (50%) patients. Surgical reconstruction failed ultimately in two (14.3%) patients who still have a colostomy and do not wish any further reconstruction. Conclusions: Our study has several limitations, including its retrospective nature and the heterogeneity of our small patient cohort. Nonetheless, although surgical reconstruction of URF may be extremely difficult and complex in the non-surgical/energy ablation patients, its successful reconstruction is possible in most through a transperineal, or a more aggressive abdominoperineal, approach with tissue interposition in selected patients.

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“…In perineal repair [8], the rectum has to be dissected and pushed posteriorly and the urethra anteriorly, the fistulous tract is resected and the opening of the prostate or urethra and rectum are closed in layers.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The first case of rectourethral fistula (RUF) was de scribed by Wagnerum [1] in 1685 and Astley Cooper [2] performed the first surgical treatment in 1823, but it was not until 1888 that Cripps [ rior perineal approach; transanal [7]; anterior perineal approach [8], and Bevan-Mason [9,10], The transrectoanal-sphincter approach was described by Bevan [9] in 1917 to treat tumors of the rectum locally. It was in 1969 that York-Mason [10] used this same approach to treat RUFs.…”

Section: Introductionmentioning

confidence: 99%

Management and Treatment of Eighteen Rectourethral Fistulas

J¹,

J²,

J³

et al. 1985

Eur Urol

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Rectourinary Fistula: Principles of Management and A Technique of Surgical Closure

Cited by 107 publications

References 6 publications

Surgical Treatment of Rectourethral Fistulae

Surgical Treatment of Rectourethral Fistulae

Management of iatrogenic urorectal fistulae in men with pelvic cancer

Management and Treatment of Eighteen Rectourethral Fistulas

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