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Rectal perforation after retropubic radical prostatectomy: occurrence and management
M Häggman1, S Brändstedt, B J Norlen
1Department of Urology, University Hospital, Uppsala, Sweden.
European Urology
|January 1, 1996
Summary
Rectal perforations during retropubic radical prostatectomy are manageable with prompt recognition and primary suture. This approach ensures favorable outcomes without routine colostomy or extensive preoperative preparation.
Area of Science:
- Urology
- Surgical Oncology
- Gastroenterology
Background:
- Rectal perforations can occur during retropubic radical prostatectomy.
- Management and outcomes of these injuries require careful assessment.
Purpose of the Study:
- To audit the management of rectal perforations during retropubic radical prostatectomy.
- To assess the incidence, risk factors, management, and outcomes of rectal injuries.
Main Methods:
- A review of 10 cases (3.6%) of rectal injury out of 270 prostatectomies.
- Injuries were immediately recognized and treated with primary suture, anal dilatation, and antibiotics.
- One case involved a temporary colostomy.
Main Results:
- Uneventful recovery in all cases.
- Postoperative hospitalization was minimally extended in cases without fecal diversion.
- No fistulae or wound infections were observed; colostomy closure had minor complications.
Conclusions:
- Prompt recognition and primary suture are key for managing rectal perforations during prostatectomy.
- Extensive preoperative preparation (bowel prep, antibiotics, omental interposition, colostomy) is not routinely necessary.
- Rectal injuries should not impede necessary preoperative investigations or treatments.