A Case of Rectourethral Fistula after a Radical Retropubic Prostatectomy in which Construction of a Bladder Fistula Contributed to the Healing

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  • 膀胱瘻の造設が治癒に寄与したと考えられる恥骨後式前立腺全摘術後の直腸尿道瘻の1例

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A 75-year-old man underwent radical retropubic prostatectomy for prostate cancer. During this operation, a full-layer rectal injury of about 15 mm in diameter was observed in the anterior wall of the lower rectum. The damaged part was repaired and ileostomy was constructed. After surgery, a rectourethral fistula of about 10 mm occurred. We performed transanal repair, but he did not recover completely. We constructed a bladder fistula. After six months of observation, the diameter of the fistula reduced to about 3 mm, so we again closed the transanal fistula, and the urination from the anus disappeared. There has been no recurrence of the rectourethral fistula since ileostomy closure. The incidence of rectal injury, which is one of the complications of radical retropubic prostatectomy, is rare, but some migrate to a rectourethral fistula, which is a serious complication, as in this case. Once a rectourethral fistula is formed, it is often refractory. We experienced a case of a rectourethral fistula after radical retropubic prostatectomy in which construction of a bladder fistula contributed to the healing. We report this case and review the literature.

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