Management of rectal injury and rectourinary fistula from radical prostatectomy
Issued Date
2023-01-01
Resource Type
ISSN
09747796
eISSN
09747834
Scopus ID
2-s2.0-85147912251
Journal Title
Urology Annals
Volume
15
Issue
1
Start Page
31
End Page
34
Rights Holder(s)
SCOPUS
Bibliographic Citation
Urology Annals Vol.15 No.1 (2023) , 31-34
Suggested Citation
Luchaichana N., Ramart P. Management of rectal injury and rectourinary fistula from radical prostatectomy. Urology Annals Vol.15 No.1 (2023) , 31-34. 34. doi:10.4103/ua.ua_179_21 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82580
Title
Management of rectal injury and rectourinary fistula from radical prostatectomy
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Objective: This study aimed to demonstrate our management of rectal injury (RI) and rectourinary fistula (RUF) from radical prostatectomy (RP) and identify a possible factor that increased the chance of developing RUF. Materials and Methods: Between January 2011 and December 2019, a total of 14 cases of RI were retrospectively reviewed and analyzed, including preoperative, perioperative, and postoperative information. Results: In all 14 cases of RI, the average age at RP was 66.3 years (54-77). During the study period, 8 of 14 cases of RI occurred in our hospital, and the incidence of RI was 0.42%. RI was intraoperative recognition in 8 cases and delayed diagnosis in 6 cases. For immediate recognition, 4 of 8 cases were primarily repaired without developing RUF and did not require diverting colostomy and suprapubic cystostomy. RUF occurred in 10 cases including 4 cases of intraoperative recognition and all cases of delayed diagnosis. In a subgroup analysis of RI that occurred in our hospital, the timing for diagnosis was clinically and statistically significant difference (P = 0.029). Instantly detected RI during RP and intraoperative rectal repair resulted in no postoperative complication. Among all 10 cases of RUF, 5 cases were successfully repaired by modified York-Mason procedure with dartos tissue flap interposition. No major complications were reported. Conclusions: Incidence of RI was 0.42% and intraoperative recognition of RI was a key to prevent the development of RUF. Modified York-Mason procedure with dartos tissue flap interposition was an effective treatment for RUF.