Surgical Treatment Of Recto-Urinary Fistula - York Mason Technique (SIU 2011)

  • uploaded: Aug 22, 2011
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Aug 22, 2011 / Duration: 04:13 / Views: 363 / 0 comments

Authors:

Fernando Ferrito, Pedro Bargao Santos, Rocha Pires

Institution:

Department of Urology, Department of General Surgery, Amadora, Portugal

Abstract

Introduction: Recto-urinary fistulas resulting from trauma or surgery are a serious and debilitating complication. They represent a challenge not only because of the difficulty on choosing the best technique to solve them but also because of the risk of recurrence. Spontaneous cure is rare. Materials and Methods: We describe the case of a 61 years old man that on the 9th postoperative day of a laparoscopic radical prostatectomy (LRP) started with fecaluria and liquid faeces. Recto-urinary fistula was confirmed at the 10th post-operative day by CT scan and contrast enema. Discussion: We chose the York-Mason technique, because it is simple to perform, effective and has minimal morbidity. This is a posterior, transrectal and transsphincteric approach, carried out on healthy tissues without previous scarring phenomena. Results: The postoperative period progressed without complications and the patient discharged on the 4th day. The closure of the fistula was confirmed radiologically by retrograde cystography after 4 weeks allowing the removal of drainage catheter. The reconstruction of intestinal transit was carried out 2 months later. Conclusion: The York-Mason technique, a transrectal and transsphincteric approach with minimal morbidity, proved to be effective on the resolution of the recto-urinary fistula, a rare complication of the radical prostatectomy.

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