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Successful Urethrorectal Fistula Repair Using GelPOINT Path Anal Access Sheath in Pelvic Fracture Urethral Injury
Wataru Tanaka1, Akihiro Kanematsu1, Naohito Beppu2
1Department of Urology Hyogo Medical University Hyogo Japan.
IJU Case Reports
|July 3, 2025
Summary
A novel transanal approach using a specialized device successfully repaired a rectourethral fistula in a young male patient with urethral trauma. This minimally invasive technique offers an effective alternative for complex fistula treatment.
Area of Science:
- Urology
- Surgical Innovation
- Trauma Management
Background:
- Rectourethral fistulas are rare but serious complications of pelvic and urethral trauma.
- Traditional surgical repair methods can be complex and associated with significant morbidity.
Purpose of the Study:
- To present a case of rectourethral fistula secondary to urethral trauma.
- To evaluate the efficacy of a transanal exposure device for fistula repair.
Main Methods:
- A young male patient with a pelvic fracture and urethral injury underwent imaging, confirming an urethrorectal fistula.
- Surgical repair involved transperineal excision and primary anastomosis urethroplasty.
- The fistula was primarily closed using a transanal GelPOINT Path access sheath, followed by perineal reinforcement with a gracilis muscle flap.
Main Results:
- The transanal device provided excellent access to the anal canal for fistula closure.
- Postoperative outcomes demonstrated excellent urethral patency.
- No recurrence of the rectourethral fistula was observed.
Conclusions:
- Transanal closure of urethrorectal fistulas using a specialized access device is a viable and effective surgical option.
- This technique may offer advantages in terms of access and potentially reduced morbidity compared to traditional methods.
