ABSTRACT
BACKGROUND: Rectourethral fistula is a rare disease with a difficult surgical treatment. The etiology of rectourethral fistula is iatrogenic, secondary to prostate surgery, pelvic radiotherapy and a rare complication of rectal surgery. Surgical treatment options for rectourethral fistula are diverse. Interposition of gracilis muscle has a curative index of 100% with close surveillance, as reported by Nyham. CLINICAL CASE: We present a case of a 58-year-old male with iatrogenic rectourethral fistula secondary to radical prostatectomy and who was treated with interposition of the gracilis muscle. Eight weeks after surgery and with colostomy closed, no evidence of recurrence was detected. CONCLUSIONS: Interposition of the gracilis muscle requires a multidisciplinary approach and demonstrates good shortterm results.