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Updated: Jun 18, 2025

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[Rectal biopsies in radioproctopathy].

Fredrik Liedberg1, Gediminas Baseckas2, Pamela Buchwald3

  • 1urolog, VO urologi, Skånes universitetssjukhus Malmö; institutionen för translationell medicin, Lunds universitet.

Lakartidningen
|August 5, 2024
PubMed
Summary

Rectal biopsies can lead to urorectal fistulas, which are difficult to treat conservatively. Radical surgery is often limited by patient comorbidities, highlighting the need for careful consideration of biopsy procedures in radioproctopathy.

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Area of Science:

  • Gastroenterology
  • Urology
  • Surgical Oncology

Background:

  • Radioproctopathy management often involves difficult clinical decisions.
  • Rectal biopsies are generally discouraged in patients with radioproctopathy.
  • Urorectal fistulas represent a serious complication with significant morbidity.

Purpose of the Study:

  • To describe the clinical characteristics of urorectal fistulas following rectal biopsies in radioproctopathy patients.
  • To evaluate the efficacy of conservative and surgical treatment options.
  • To discuss diagnostic challenges and limitations for radical treatment.

Main Methods:

  • Retrospective case series of five patients.
  • Clinical data review including patient history, biopsy details, fistula presentation, and treatment outcomes.
  • Analysis of diagnostic modalities and surgical interventions.

Main Results:

  • Five cases of urorectal fistulas were identified post-rectal biopsy.
  • Conservative management showed limited success in fistula closure.
  • Radical surgical options, such as pelvic exenteration, were often precluded by patient comorbidities.

Conclusions:

  • Rectal biopsies in radioproctopathy pose a risk of developing complex urorectal fistulas.
  • Successful treatment of these fistulas is challenging, with conservative measures rarely effective.
  • Comorbidities significantly impact the feasibility of radical surgical interventions, necessitating a cautious approach to biopsies.