Nonoperative management of iatrogenic prostatorectal fistula

Iatrogenic prostatorectal fistula is a rarely seen urologic complication of transurethral resection of the prostate and stricture dilatation with sounds. In the past, such cases have been managed with colostomy diversion of the fecal stream and suprapubic cystostomy diversion of the urinary stream and in most cases operative closure of the fistula. This case illustrates that a more conservative nonoperative approach can lead to successful closure of such a fistula in selected cases. The management of the case described here utilizes low residue dietary supplements, Foley catheter drainage, and broad-spectrum antibiotics to allow the fistula to heal.