Surgical treatment of rectourethral fistula / 现代泌尿外科杂志

Rectourethral fistula (RUF) has been difficult to manage in urology due to its special anatomical location,complicated condition and uncertain prognosis. With the increasing incidence of prostate cancer,the incidence of RUF as a serious complication is also rising. Major treatment methods of RUF include conservative treatment and surgical treatment such as transabdominal approach,trans-perineal approach,trans-sphincter approach and trans-anal approach. However,there is no explicit treatment protocol. In recent years,the application of modified York-Mason technique has achieved good results. This article details the key steps and surgical experience of the technique.

Treatment of a Recurrent Rectourethral Fistula by Using Transanal Rectal Flap Advancement and Fibrin Glue: A Case Report

Rectourethral fistulas (RUFs) in adults are rare and could result from complicated trauma, and prostatic or rectal surgery. RUFs have been treated initially by using primary repair and omental interposition with or without a colostomy during surgery. Recurrent RUFs require complex surgery, such as a low rectal resection and coloanal anastomosis, an interposition flap of the datos muscle or gracilis muscle, and others. Recently, transanal rectal flap advancement and fibrin glue injection have provided an effective occlusion of RUFs. However, no reports about this technique exist for cases of recurrent RUFs. We report a case of a recurrent RUF successfully repaired by using transanal rectal flap advancement combined with fibrin glue injection into the fistula tract. The postoperative course was uneventful without complications. At the 1-year follow-up, no complications such as urethral stricture or recurrence existed, and voiding was normal without anal incontinence.

The surgical repair of rectourethral fistula:island skin tubes from perineum and scrotum were adopted / 临床外科杂志

Objective To study a new procedure of surgical repairment of rectourethral fistula.Method By the perineum approach one stage urethroplasty using island skin tubes from perineum and scrotum has been adopted after the resection of fistular urethra and repairment of the defect of the anterior wall of rectum to substitute the defect of urethra in 9 cases during 1992-1998.Result The 9 cases were all cured and have been followed-up for 2 6 years without recurrence of rectourethral fistula.Conclusion This procedure was regarded as an ideal technique for the closure of rectourethral fistula especially for those complicated with urethra stricture.