Rectourethral Fistula Management Via Urological Prospective

Abstract

Rectourethral fistula is a rare condition with multiple etiology. The surgical treatment is a challenge as the site is difficult to reach and also there are usually several associated comorbidities from the etiological cause which needs to be dealt with. This pathology involves different speciality i.e., general surgery, colorectal surgery, minimal access surgery, urology and reconstructive surgery etc. This being one of the reasons that several different surgical technique and approaches are devised to treat this condition. Our study is based on 19 patients in whom the etiology was trauma. The surgical approach was transperineal andwe utilizing scrotal fibrofatty vascularized flap for interposition layer. We had 89.5% (n=17) success rate and10.5% (n=2) recurrence. It is therefore concluded that perineal approach is safe and far less complication.It is also important to place vascularize interposition tissue flap for successful outcome.While more radical trans sphincteric approach with defunctional colostomy should only be reserved for more complex and recurrent cases.