Rajaian Shanmugasundaram, Pragatheeswarane Murugavaithianathan, Krishnamurthy Karrthik, Murugasen Lakshman
Department of Urology, MIOT International, Manapakkam, Chennai, India
Department of Urology, MIOT International, Manapakkam, Chennai, India.
BMJ Case Rep. 2020 Jan 5;13(1):e230804. doi: 10.1136/bcr-2019-230804.
We report a case of iatrogenic rectourethral fistula (RUF) in an elderly man with benign prostatic enlargement and acute urinary retention, following a transurethral resection of prostate (TURP). This patient presented a unique challenge of tackling the RUF in the presence of a large residual prostate gland and urinary tract infection. RUF was repaired only after getting the access to the fistula following transvesical prostatectomy. Follow-up imaging showed well-healed repair of RUF. Transvesical prostatectomy is a useful adjunctive procedure in repair of RUF when associated with a large prostate. This case also highlights the importance of technique selection while planning for surgery on large prostate glands. TURP is not the preferred first modality of choice for larger glands as noted in this case.
我们报告一例老年男性医源性直肠尿道瘘（RUF）病例，该患者患有良性前列腺增生和急性尿潴留，在经尿道前列腺切除术（TURP）后发生了这种情况。该患者面临着在存在大量残余前列腺组织和尿路感染的情况下处理RUF的独特挑战。仅在经膀胱前列腺切除术后找到瘘口后才对RUF进行修复。随访影像学检查显示RUF修复良好。当RUF与大前列腺相关时，经膀胱前列腺切除术是修复RUF的一种有用的辅助手术。该病例还强调了在计划对大前列腺进行手术时技术选择的重要性。如本病例所示，对于较大的腺体，TURP并非首选的初始治疗方式。
