[Rectourethral fistula after radical retropubic prostatectomy: a case report]

Area of Science:

• Urology
• Gastroenterology
• Surgical Oncology

Background:

• Radical retropubic prostatectomy (RRP) is a standard treatment for prostate cancer.
• Rectourethral fistula is a rare but serious complication following RRP.
• Early diagnosis and management are crucial for optimal patient outcomes.

Observation:

• A 56-year-old male developed fecaluria on postoperative day 8 after RRP, indicating a rectourethral fistula.
• Initial conservative management included a diverting colostomy and urethral catheter drainage.
• Spontaneous fistula closure occurred 3 months post-RRP.

Findings:

• A transanal repair using a rectal wall advancement flap procedure was successfully performed 8 months after RRP.
• The patient experienced an uneventful postoperative recovery.
• The colostomy was closed, and normal voiding and anal continence were restored by April 2009.

Implications:

• This case demonstrates the efficacy of a combined conservative and surgical approach for rectourethral fistula.
• Successful repair restored quality of life, including normal urinary and bowel function.
• The rectal wall advancement flap technique offers a viable option for managing complex rectourethral fistulas.