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Management of urethro rectal fistulae: experience utilising the York Mason approach
Author(s) -
GRAY K.M.,
WINKLE D.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06085_98.x
Subject(s) - medicine , surgery , anal stenosis , prostatectomy , fistula , urinary incontinence , urinary diversion , stenosis , radical retropubic prostatectomy , prostate , general surgery , cystectomy , radiology , cancer , bladder cancer , hemorrhoids
Urethro rectal fistulae are a rarely seen clinical entity. These fistulae pose a difficult problem to the treating urologist. The majority of cases require surgical repair. Different approaches to surgical correction have evolved over time. We report our hospitals experience utilising the posterior transphincteric approach. Patients and Methods: Six patients in our hospital have undergone repair of this type over a two year period. Three fistulas occurred after radical retropubic prostatectomy. The remainder as a result of laser prostatectomy, transurethral resection of the prostate and rectal surgery. Five of these underwent preoperative faecal and urinary diversion. Once treatment was complete data was reviewed retrospectively. Results: All patients had a favourable outcome postoperatively. No faecal nor urinary incontinence is reported. No anal stenosis has developed. Postoperative recovery is rapid with minimal morbidity. Conclusion: Posterior transphincteric approach provides excellent exposure through healthy tissue planes. Favourable repair with symptom resolution was obtained in all patients treated at our hospital with minimal morbidity.