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Rectourethral Fistula: Transanal, Transperineal, and Posterior Approaches

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Urinary Fistula

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Abstract

Rectourethral fistula (RUF) is an uncommon congenital or acquired entity in which an abnormal connection forms between the rectum and the urethra. Prostate cancer treatment is the most common cause of acquired RUF. The management of RUFs requires a tailored approach specific to each patient. Important factors to consider include the fistula etiology, size, and location in relation to anatomical structures. Other variables include the expected degree of urethral stricture after surgical closure, the previous attempts at surgical repair, and the local tissue quality. Repair methods can be simplified as working from above, requiring an anterior or transabdominal approach, or from below, meaning the transanal, transperineal, and posterior techniques.

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Abbreviations

AIDS:

Acquired immune deficiency syndrome

BMI:

Body mass index

CT:

Computed tomography

ERAF:

Endorectal advancement flap

GI:

Gastrointestinal

HIFU:

High-Intensity Focused Ultrasound

HIV:

Human immunodeficiency virus

MRI:

Magnetic resonance imaging

RUF:

Rectourethral fistula

TAMIS:

Transanal minimally invasive surgery

TEM:

Transanal endoscopic microsurgery

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Author information

Authors and Affiliations

  1. Division of Colorectal Surgery, Keck School of Medicine, Los Angeles, CA, USA

    Jordan Wlodarczyk

  2. Keck School of Medicine, Los Angeles, CA, USA

    Christine Hsieh

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  1. Jordan Wlodarczyk
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  2. Christine Hsieh
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Correspondence to Christine Hsieh .

Editor information

Editors and Affiliations

  1. Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA

    René Sotelo

  2. Capital Health – Urology Specialists, Capital Health Medical Center, Pennington, NJ, USA

    Charles F. Polotti

  3. School of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, Mexico

    Juan Arriaga

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Wlodarczyk, J., Hsieh, C. (2022). Rectourethral Fistula: Transanal, Transperineal, and Posterior Approaches. In: Sotelo, R., Polotti, C.F., Arriaga, J. (eds) Urinary Fistula. Springer, Cham. https://doi.org/10.1007/978-3-031-15317-4_18

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  • DOI: https://doi.org/10.1007/978-3-031-15317-4_18

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