دورية أكاديمية
Management of iatrogenic rectourethral fistula.
| العنوان: | Management of iatrogenic rectourethral fistula. |
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| المؤلفون: | Nyam DC; Division of Colon and Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA., Pemberton JH |
| المصدر: | Diseases of the colon and rectum [Dis Colon Rectum] 1999 Aug; Vol. 42 (8), pp. 994-7; discussion 997-9. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Country of Publication: United States NLM ID: 0372764 Publication Model: Print Cited Medium: Print ISSN: 0012-3706 (Print) Linking ISSN: 00123706 NLM ISO Abbreviation: Dis Colon Rectum Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia. Lippincott |
| مواضيع طبية MeSH: | Intestinal Fistula/*surgery , Rectal Diseases/*surgery , Urethral Diseases/*surgery , Urinary Fistula/*surgery, Aged ; Aged, 80 and over ; Brachytherapy/adverse effects ; Colostomy/adverse effects ; Female ; Humans ; Iatrogenic Disease ; Intestinal Fistula/etiology ; Intestinal Fistula/pathology ; Male ; Middle Aged ; Prostatectomy/adverse effects ; Plastic Surgery Procedures/methods ; Rectal Diseases/etiology ; Rectal Diseases/pathology ; Retrospective Studies ; Treatment Outcome ; Urethral Diseases/etiology ; Urethral Diseases/pathology ; Urinary Fistula/etiology ; Urinary Fistula/pathology |
| مستخلص: | Purpose: Rectourethral fistulas are uncommon, usually iatrogenic injuries that are challenging to treat. Our aim was to determine a logical approach to surgical treatment of this often debilitating problem. Methods: Records of all patients who were diagnosed with rectourethral fistula between January 1981 and December 1995 were reviewed and 16 males were identified. All but three patients had had intervention for their prostatic malignancy performed elsewhere. All patients were interviewed by telephone to establish follow-up. The mean age of the sixteen patients was 68 years. The mean follow-up was 80 months. Adenocarcinoma of the prostate in 15 patients and recurrent transitional cell epithelioma of the bladder in one patient were the underlying malignant diseases. Seven patients had a radical retropubic prostatectomy, two had radical retropubic prostatectomy after radiation, two had brachytherapy, and three were treated by a combination of radiation and brachytherapy. One patient formed a fistula after cystectomy and dilation of a stricture. This heterogenous group of patients received multiple therapies including initial colostomy (7 patients), transanal repair (2 patients), parasacral repair (2 patients), transperineal repair (2 patients), coloanal anastomosis (3 patients), and muscle transposition (3 patients). Four of our patients required a permanent stoma. Conclusion: In patients with iatrogenic rectourethral fistula that occurred after radical retropubic prostatectomy or radiation, fecal and urinary diversion and muscle transposition followed by re-establishment of both urinary and intestinal continuity may be the treatment modality of choice. |
| تواريخ الأحداث: | Date Created: 19990824 Date Completed: 19990908 Latest Revision: 20221207 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1007/BF02236689 |
| PMID: | 10458120 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0012-3706 |
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| DOI: | 10.1007/BF02236689 |