Rectourethral and Complex Fistulas: Evaluation and Management

Jan Rakinic, W. Brian Perry
Rectourethral and Complex Fistulas: Evaluation and Management is a topic covered in the ASCRS Textbook of Colon and Rectal Surgery.

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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.

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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.

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Last updated: January 26, 2022