Experience of 18 cases of Rectourethral Fistula
S M Mahbub Alam, MA Awal, Amanur rasul , Md Mizanur Rahman, Md Shafiqul Alam Chow, Md Fazal Naser, Md Faisal Islam; Department of Urology, Dhaka Medical College Hospital.
Rectourethral fistula is a rare occurrence following pelvic trauma or surgery of the prostate gland. There are various methods of repair of these fistulas with advantages in each method. Here we express our experience in York-Mason repair & perineal approach with graft interposition according to the need in different situation.
Materials & Methods:
We prospectively reviewed the record of all the patients who developed recturethral fistula. Total 18 patients were included and in all cases faecal and urinary diversion was done preoperatively. In 4 patients spontaneous closure occur after 6 months. In 8 patients repair was done through perineal approach & in the remaining 6 patients Yark-Mason repair was done.
Out of 6 patients of Yark-Mason repair, one developed recurrent fistula—who underwent repair through perineal approach later on with good result. No patient developed urinary or faecal incontinence. In 2 patients leakage of urine was noted in the perineal wound. No one had erectile dysfunction.
Both faecal & urinary diversion adds benefit to the outcome of the rectourethral fistula. Posterior transphicteric approach is easier to do with less morbidity and complication while perineal approach with graft interposition may be done in cases where anastomotic urethroplasty is neeeded along with fistula repair.
Key Words: fistula, rectal fistula, urinary fistula.