Surgical Treatment of Rectourinary Fistulas: Review of the Literature

Abstract

Background A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation, or trauma. Retrospective studies and case reports have highlighted different approaches for surgical repair. Objective The aim of this study was to review our experience with surgical management of RUF. Data sources MEDLINE (PubMed, Ovid) and the Cochrane Library were searched by using the terms RUFs urethrorectal fistulas, and prostatourethral-rectal fistulas. Study selection All studies were retrospective and in English. Of the records identified, 31 series were included. Results Four hundred sixty-five patients were identified. Most patients underwent one of four categories of repair: transanal (4.7%), transabdominal (14.1%), transsphincteric (26.6%), and transperineal (57.6%). Tissue interposition flaps, predominantly gracilis muscle, were used in 56% of repairs. The fistula was successfully closed in 93.9% of patients. Conclusions Regardless of complexity, RUFs have an initial closure rate of 93.9%.