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Minimally Invasive Repair of a Prostatorectal Fistula with an Over-the-Scope Rectal Clip
Burkhard Ubrig1, Ekkehard Schmidt-Heikenfeld2, Stephan Degener1
1Department of Urology, Augusta-Kranken-Anstalt gGmbH, Witten/Herdecke University, Bochum, Germany.
Journal of Endourology Case Reports
|November 4, 2017
Summary
This study reports the first successful closure of a prostatorectal fistula using an endoscopic rectal clip. This minimally invasive technique offers an effective alternative to major surgery for treating rare urethral-rectal fistulas.
Area of Science:
- Urology
- Gastroenterology
- Surgical Innovation
Background:
- Prostatorectal fistulae are rare, often resulting from surgery or predisposing factors like immunosuppression.
- Traditional repair methods for these fistulae typically involve extensive surgical procedures.
Observation:
- A 64-year-old male patient with chronic immunosuppression developed an iatrogenic prostatorectal fistula post-transurethral resection of the prostate.
- Conservative management with a colostomy failed to achieve fistula healing.
Findings:
- The study details the first successful application of an endorectal "over-the-scope" clip for closing a prostatorectal fistula.
- The clip effectively sealed the fistula, leading to the reversal of the colostomy and unimpaired micturition at 32-month follow-up.
Implications:
- Endoscopic clip closure presents a potentially less invasive and effective treatment option for select cases of prostatorectal fistulae.
- This approach may reduce the need for major reconstructive surgery in managing these complex conditions.
