A novel approach to the repair of urethrocutaneous fistulae arising after abdominoperineal anorectal resection

Authors

  • Alaya Yassein Division of Urology, McMaster University, Hamilton, ON, Canada
  • Shawn Dason Division of Urology, McMaster University, Hamilton, ON, Canada
  • Stephen Kelly Division of Surgery, McMaster University, Hamilton, ON, Canada
  • Timothy Davies Division of Urology, McMaster University, Hamilton, ON, Canada

DOI:

https://doi.org/10.5489/cuaj.2938

Abstract

This case report describes a novel approach to the repair of perineal urethrocutaneous fistulae (UCF) after abdominoperineal resection (APR). A 62-year-old patient developed a UCF after an APR for rectal cancer complicated by perineal abscess formation. The patient presented with continuous urinary drainage from the fistula that persisted despite a number of conservative and surgical measures. The patient underwent successful repair of the urethrocutaneous fistula in prone position—an approach that has not previously been described in the literature. Repair was performed by the multidisciplinary team of a reconstructive urologist, colorectal surgeon, and plastic surgeon. Post-operative retrograde urethrogram demonstrated the absence of a persistent fistula tract and the patient has been continent for 18 months. The prone approach for UCF repair allows for excellent access to the fistula tract for posterior urethroplasty in a patient that has had prior APR.

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Author Biographies

Stephen Kelly, Division of Surgery, McMaster University, Hamilton, ON, Canada

Associate Professor, General/Colorectal Surgery

Timothy Davies, Division of Urology, McMaster University, Hamilton, ON, Canada

Assistant Professor, Division of Urology

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Published

2015-12-14

How to Cite

Yassein, A., Dason, S., Kelly, S., & Davies, T. (2015). A novel approach to the repair of urethrocutaneous fistulae arising after abdominoperineal anorectal resection. Canadian Urological Association Journal, 9(11-12), E879–81. https://doi.org/10.5489/cuaj.2938