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Transanal endoscopic microsurgical repair of iatrogenic recto-urethral fistula
1Department of Colorectal Surgery, The Adelaide & Meath Hospital, Incorporating the National Children's Hospital, Ireland.
Background:
Recto-urethral fistula formation following radical prostatectomy is an uncommon but potentially devastating event. Traditional surgery for such fistulae is technically demanding, jeopardizes continence and usually necessitates a diverting colostomy. We present the case of an iatrogenic fistula treated by a transanal endoscopic microsurgical approach, without recourse to a stoma.
Method:
A 71-year-old man had recently undergone a radical prostatectomy, complicated by significant intra-operative haemorrhage. He subsequently developed a recto-urethral fistula, confirmed clinically and endoscopically. Due to his bleeding diathesis, he was considered for, and underwent, a transanal endoscopic microsurgical (TEMS) repair.
Conclusion:
TEMS is a safe and reliable minimally-invasive surgical technique for the treatment of this difficult condition.
