Key Concepts

• Rectourethral fistula (RUF) is an uncommon but potentially devastating condition which may significantly impact a patient’s quality of life.
• Treatment of prostate cancer is most common etiology.
• Up to 45% of simple RUF may heal with fecal diversion alone.
• Ultimate repair may be quite complex, involving a multispecialty team approach over the course of several procedures.
• Surgical repair with interposition of well-vascularized tissue has good outcomes, though radiation confers higher risk for permanent fecal or urinary diversion.