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Successful Repair of Iatrogenic Rectourinary Fistulas Using the Posterior Sagittal Transrectal Approach (York-Mason): 15-Year Experience

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Abstract

Introduction

Rectourinary fistulas (RUFs) represent a challenging clinical problem. Most RUFs are secondary to lower urinary or intestinal tract surgery. Several surgical approaches have been proposed. The aim of this study was to review a 15-year experience using the York-Mason posterior sagittal transrectal approach to iatrogenic RUFs.

Methods

Seven patients with RUFs secondary to urologic surgery were operated on with the York-Mason technique at the Department of Urology, University of Padova, Italy between 1988 and 2003. The patients’ data have been collected and analyzed retrospectively.

Results

All the patients were treated successfully (100%). In one patient with Crohn’s disease the fistula recurred 11 years after the first surgery. One patient died for metastasis of prostate cancer 1 year after surgical repair of the RUF. A temporary colostomy was performed in five patients; the colostomies were subsequently closed, and the patients regained complete fecal continence with no postoperative anal strictures. The colostomy remained in place in one patient with Crohn’s disease and in another with ulcerative rectocolitis.

Conclusions

The posterior sagittal transrectal approach provided easy access and identification of RUFs and good surgical exposure, with no subsequent strictures or fecal incontinence. Our data show that the York-Mason technique alone is a highly effective option for treating an iatrogenic postoperative RUF.

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Acknowledgment

The authors thank Mrs. Mirna Segato, PhD, for her assistance with the imaging and the original hand drawings.

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Authors and Affiliations

  1. Department of Urology, University of Padova Medical School, Via Giustiniani 2, Padova, I-35128, Italy

    Fabrizio Dal Moro MD, Mariangela Mancini MD, Francesco Pinto MD, Nicola Zanovello MD, Pier Francesco Bassi MD & Francesco Pagano MD, FACS

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  1. Fabrizio Dal Moro MD
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  2. Mariangela Mancini MD
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  3. Francesco Pinto MD
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  4. Nicola Zanovello MD
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  5. Pier Francesco Bassi MD
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  6. Francesco Pagano MD, FACS
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Correspondence to Fabrizio Dal Moro MD.

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Moro, F.D., Mancini, M., Pinto, F. et al. Successful Repair of Iatrogenic Rectourinary Fistulas Using the Posterior Sagittal Transrectal Approach (York-Mason): 15-Year Experience. World J. Surg. 30, 107–113 (2006). https://doi.org/10.1007/s00268-005-7940-8

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  • DOI: https://doi.org/10.1007/s00268-005-7940-8

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