Yetişir Fahri, Şarer A Ebru, Acar H Zafer, Parlak Omer, Osmanoglu Gokhan, Karalova Gulen
General Surgery Department, Atatürk Research and Training Hospital, Turkey.
Anesthesiology and Reanimation Department, Atatürk Research and Training Hospital, Turkey.
Case Rep Urol. 2015;2015:854365. doi: 10.1155/2015/854365. Epub 2015 Dec 6.
Rectourethral fistula (RUF) may develop after ureterovesical and rectal intervention or radiation therapy (RT) rarely, but it is associated with significant morbidity and mortality. The patient will typically present with pneumaturia, faecaluria, and urinary drainage from the rectum. Diagnosis can be easily done with digital rectal examination, cystography, and urethrocystoscopy. Conservative supportive management of RUF does not appear to be successful in most patients, and management with surgical intervention remains the best treatment option. Several surgical techniques have been described including transabdominal, transanal, transperineal, combined abdominoperineal, anterior and posterior transsphincteric, transsacral, laparoscopic, robotic, and endoscopic minimally invasive approaches. There have been very few data about treatment of recurrent RUF. We would like to report the management of recurrent RUF following transurethral resection of prostate and RT for prostate carcinoma in an immunosuppressed, 75-year-old patient by York Mason posterior transrectal transsphincteric approach.
直肠尿道瘘（RUF）很少在输尿管膀胱和直肠干预或放射治疗（RT）后发生，但它与显著的发病率和死亡率相关。患者通常会出现气尿、粪尿以及直肠尿液引流。通过直肠指检、膀胱造影和尿道膀胱镜检查可以轻松做出诊断。在大多数患者中，RUF的保守支持治疗似乎并不成功，手术干预仍是最佳治疗选择。已经描述了几种手术技术，包括经腹、经肛、经会阴、联合腹会阴、前后经括约肌、经骶骨、腹腔镜、机器人辅助和内镜微创方法。关于复发性RUF治疗的数据非常少。我们想报告一名75岁免疫抑制患者在前列腺癌经尿道前列腺切除和RT后发生复发性RUF，采用约克·梅森经直肠经括约肌后入路的治疗情况。
