Trocar injuries in laparoscopic surgery

Although rectourinary fistula (RUF) after radical prostatectomy (RP) is rare, it is an important issue impairing the quality of life of patients. If the RUF does not spontaneously close after colostomy, surgical closure should be considered. However, there is no standard approach and no consensus in the literature. A National Center for Biotechnology Information (NVBI) PubMed search for relevant articles published between 1995 and December 2010 was performed using the medical subject headings “radical prostatectomy” and “fistula.” Articles relevant to the treatment of RUF were retained. RUF developed in 0.6% to 9% of patients after RP. Most cases required colostomy, but more than 50% of them needed surgical fistula closure thereafter. The York-Mason technique is the most common approach, and closure using a broad-based flap of rectal mucosa is recommended after excision of the RUF. New techniques using a sealant or glue are developing, but further successful reports are needed.

https://downloads.hindawi.com/journals/pc/2011/629105.pdf

Rectourinary Fistula after Radical Prostatectomy: Review of the Literature for Incidence, Etiology, and Management

Effect of prior radiotherapy and ablative therapy on surgical outcomes for the treatment of rectourethral fistulas.

Management of acquired rectourethral fistulas in adults.

Rectourethral fistula (RUF) is a rare condition that occurs, in most cases, as a consequence of prostate cancer treatments. Clinical suspicion and proper assessment prior to surgery are essential to adapt and successfully carry out an appropriate treatment plan. There are no randomized trials to guide clinical practice, and therefore, scientific evidence in this respect is limited. Expert recommendations seem to agree on the transperineal approach with flap interposition as the surgical treatment of choice in cases of complex fistulas, especially in those that have undergone prior radiation. Undoubtedly, the key to the successful treatment of the disease is the multidisciplinary and standardized management by physicians with experience in the field.

Rectourethral Fistula Management

Laparoscopic Repair of Rectourethral Fistulas After Prostate Surgery

https://europeanurology.com/article/S0302-2838(15)00856-8/pdf/safer-surgery-by-learning-from-complications-a-focus-on-robotic-prostate-surgery

Mariano Mirandolino

Papers

Laparoscopic Repair of Rectourethral Fistulas After Prostate Surgery

Safer Surgery by Learning from Complications: A Focus on Robotic Prostate Surgery.

Laparoscopic Repair of Rectourethral Fistulas After Prostate Surgery

Adult Urology Laparoscopic Repair of Rectourethral Fistulas After Prostate Surgery