Open AccessPenile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy
Author(s) -
John Kinahan,
Howard Pai,
Mildred Martens,
Jason Gray,
Darren Biberdorf,
Alex Mihailovic,
Iain McAuley
Publication year - 2014
Publication title -
canadian urological association journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.477
H-Index - 38
eISSN - 1920-1214
pISSN - 1911-6470
DOI - 10.5489/cuaj.1112
Subject(s) - medicine , penectomy , brachytherapy , fistula , surgery , radiation therapy , penis , prostate cancer , urethra , external beam radiotherapy , perineum , urinary fistula , pelvic exenteration , urethrostomy , radiology , cancer , penile cancer
Radiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years post-external beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myocutaneuos flap closure of the perineum.