Laparoscopic transvesical urethrorectal fistula repair: a new technique

Urology
Ali S GözenJens Rassweiler

Abstract

Urethrorectal fistulas are rare, and several open operative approaches and techniques have been used in treatment. We report our preliminary experience with laparoscopic transvesical urethrorectal fistula repair after iatrogenic urethrorectal fistula. A 65-year-old man with insulin-dependent diabetes mellitus and peripheral vascular disease was hospitalized 6 months after transurethral resection of the prostate for benign prostatic hyperplasia with a recurrent urinary tract infection, fecaluria, and urine leakage from the rectum during voiding. Urethrocystoscopy revealed a urethrorectal fistula in the prostatic fossa. Primary conservative treatment failed. The patient was placed in the lithotomy position, and the suprapubic tract was dilated to allow a 10-mm telescope. Carbon dioxide gas was used to distend the bladder (15 mm Hg, flow rate 3 L/min). Next, two 3-mm pediatric trocars were inserted under direct vision. The fistula was identified and the edge of the fistula excised. A running suture (3-0 PDS, RB needle) was used to close the fistula. Finally, a 16F Foley urethral catheter was passed under direct vision, followed by a suprapubic catheter. On postoperative day 12, retrograde cystography revealed no contrast leakage f...Continue Reading

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Citations

Sep 28, 2010·Current Opinion in Urology·Jens RassweilerDogu Teber
Feb 16, 2012·Journal of Endourology·Marek RoslanKazimierz Krajka
Dec 12, 2012·Journal of Pediatric Surgery·Yunli Bi, Yufang Sun
May 27, 2014·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Marcos Tobias-MachadoAntonio Carlos Lima Pompeo

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