Abstract
Objective
To report our experience and outcomes in minimally invasive management of rectourethral
fistula (RUF).
Methods
From 2004 to 2021, 15 patients who underwent minimally invasive RUF repair by a single
surgeon at 2 international institutions were retrospectively reviewed. Baseline demographic
characteristics, perioperative, and postoperative data were collected. Complications
were reported using the modified Clavien-Dindo Classification System and the European
Association of Urology Complication Panel Assesment and Recommendations. Success was
defined as complete resolution of fistula-related symptoms at 12-month follow-up along
with confirmation of fistula closure by imaging or cystoscopy. Categorical variables
were presented as frequencies and percentages whereas continuous variables were reported
as median and quartiles.
Results
Fifteen male patients with a median age of 71 (64-79.2) years were treated. Four cases
(26.6%) occurred postsurgery, 8 cases (53.3%) occurred after energy treatments, and
3 cases (20%) after surgery combined with an energy treatment modality. A robotic
and laparoscopic approach was performed in 9 (60%) and 6 (40%) patients, respectively.
No intraoperative complications were reported. Median operative time was 264 (217.5-341)
minutes, estimated blood loss was 175 (137.5-200) mL, and the length of hospital stay
was 4 days. Nine postoperative complications were reported. All patients were followed-up
for 12 months with no recurrence reported. All patients reached our criteria for successful
RUF repair.
Conclusions
Minimally invasive surgery could represent an efficient way to manage RUF in selected
patients. More studies and treatment standardization are needed to assess the role
of minimally invasive surgery in the management of RUF.
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Article Info
Publication History
Published online: August 20, 2022
Accepted:
May 22,
2022
Received:
January 27,
2022
Footnotes
Financial Disclosure: The authors declare no conflicts of interest.
Funding Support: There was no source of funding.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
