Objective: To present our experience with a novel technique that combines the York-Mason transsphincteric approach with dartos muscle flap interposition to treat rectourethral fistulas.
Methods: We extracted records from our prospectively kept database of 35 procedures conducted for treating rectourethral fistulas during 2002-2023; the York-Mason approach was combined with dartos muscle flap interposition in 5 cases, performed for treating rectourethral fistulas due to radical prostatectomy, all of which were referral cases.
Results: All 5 patients were successfully treated and followed up for a median of 70.0 months without recurrence. Before the fistula repair, all had a diverting stoma. In all cases, the first voiding cystourethrogram revealed a healed fistula. The posterior and the scrotal incisions healed uneventfully. All patients reported normal voiding and no urinary incontinence. To date, the stoma has closed in 3 patients, all of whom had intact fecal continence and no postoperative anal stenosis.
Conclusion: The transsphincteric modified York-Mason approach combined with dartos muscle flap interposition resulted in complete healing of rectourethral fistulas.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.urology.2024.05.041 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Expert Commentary on Rectourethral Fistula.
Dis Colon Rectum
February 2025
Department of Urology, University of Washington, Seattle, Washington.
Rectourethral Fistula: Evaluation and Management.
Dis Colon Rectum
February 2025
Division of Colorectal Surgery, Keck Hospital of USC, Los Angeles, California.
Iatrogenic Proximal Urethro-Rectal Perforation During Foley Catheter Insertion.
Case Rep Surg
January 2025
Department of General Surgery, University of Balamand, Beirut, Lebanon.
Iatrogenic urethral-rectal perforation represents a rare but severe complication arising from medical interventions, notably highlighted in the context of Foley catheter insertion. This case report outlines the presentation, diagnosis, management, and outcomes of a 71-year-old male patient who experienced iatrogenic rectal perforation during the routine insertion of a Foley catheter, against the backdrop of several predisposing factors, such as atrial fibrillation, valvular disease, benign prostatic hyperplasia, urethral stenosis, and colorectal cancer with liver metastasis. The inadvertent creation of a rectourethral fistula during the procedure led to an urgent multidisciplinary approach involving surgery and postoperative management, including fecal and urine diversion and antibiotic therapy.
View Article and Find Full Text PDFSphincter-Sparing Posterior Sagittal Anorectoplasty for Rectourethral Fistulas: A Potential Refinement to Consider?
J Pediatr Surg
January 2025
Tanta University Hospital, Faculty of Medicine, Tanta University, Tanta, Egypt; Kenanah Children's Medical Center, Tanta, Egypt. Electronic address:
Rectourethral fistula after perirectal spacer placement requiring pelvic exenteration.
BMJ Case Rep
December 2024
Yale University School of Medicine, New Haven, Connecticut, USA
Despite the widespread use of perirectal spacers to reduce radiation-induced rectal toxicity during prostate cancer treatment, postmarketing data reveal rare but significant complications. This case report details a severe complication of rectourethral fistula necessitating robotic pelvic exenteration with urinary and faecal diversion following perirectal spacer placement. Although SpaceOAR has been shown to reduce rectal radiation dose, the ensuing clinical benefit remains inconclusive in real-world data.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!