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Rectourethral Fistula

  • Jack M. Zuckerman
  • Kurt A. McCammonEmail author
Chapter

Abstract

In the modern era, acquired rectourethral fistula (RUF) develops most commonly secondary to complications following the treatment of prostate cancer. Compared with historic controls, RUF seen today are frequently larger and more often associated with concomitant radiation or tissue ablation complicating attempts at surgical repair. History, physical exam, and diagnostic evaluation allow adequate characterization of the fistula tract and surgical planning, including the potential need for flap interposition during the repair. Surgical approach to the fistula may utilize either a sphincter preserving perineal technique or a prone jackknife transrectal dissection depending on surgeon experience and training. Rarely a combined abdominoperineal dissection is required. Outcomes and complications of each technique are reviewed.

Keywords

Rectourethral fistula Radiation Salvage Prostate cancer Flaps 

Abbreviations

RUF

Rectourethral fistula

RP

Radical prostatectomy

EBRT

External beam radiation therapy

XRT

Radiation therapy

TURP

Transurethral resection of the prostate

HIFU

High-intensity focused ultrasound

CT

Computed tomography

MRI

Magnetic resonance imaging

RUG

Retrograde urethrogram

VCUG

Voiding cystourethrogram

BMG

Buccal mucosa graft

SPT

Suprapubic tube

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of UrologyEastern Virginia Medical SchoolNorfolkUSA

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