Management of rectal injury and rectourinary fistula from radical prostatectomy

Autor: Nuttaphon Luchaichana, Patkawat Ramart
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Urology Annals, Vol 15, Iss 1, Pp 31-34 (2023)
Druh dokumentu: article
ISSN: 0974-7796
0974-7834
DOI: 10.4103/ua.ua_179_21
Popis: 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.
Databáze: Directory of Open Access Journals
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