title: Laparoscopic rectovesical fistula repair.
abstract: OBJECTIVE
  Rectovesical fistula (RVF) is a rare complication of radical prostatectomy. A 62- year-old man with clinically localized prostate cancer underwent open radical prostatectomy that was complicated by rectal injury and subsequent RVF development. Conservative management failed, and the patient was referred for surgical correction.
  
  
  METHODS
  The operative steps consisted of (1) cystoscopy, (2) RVF catheterization, (3) ureteral catheterization, (4) five-port transperitoneal laparoscopic approach, (5) cystotomy, (6) opening of the fistulous tract, (7) dissection between the bladder and the rectum, (8) closure of the rectum, (9) interposition of omentum, (10) suprapubic cystostomy placement, (11) bladder closure, and (12) colostomy creation.
  
  
  RESULTS
  The operative time was 240 minutes. The hospital stay was 3 days. The urethral catheter was kept indwelling for 4 days. At 8 weeks postoperatively, the suprapubic tube was removed and the colostomy reversed. At 1-month follow-up, the patient remains free of fistula recurrence.
  
  
  CONCLUSIONS
  Laparoscopic rectovesical fistula repair is feasible and represents an attractive alternative to the standard approaches.
authors.affiliation: Section of Laparoscopic and Minimally Invasive Surgery, Department of Urology, "La Floresta" Medical Institute, Caracas, Venezuela. renesotelo@cantv.net
authors.forename: Rene
authors.initials: R
authors.lastname: Sotelo
authors.forename: Alejandro
authors.initials: A
authors.lastname: Garcia
authors.forename: Henry
authors.initials: H
authors.lastname: Yaime
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rodríguez
authors.forename: Rinci
authors.initials: R
authors.lastname: Dubois
authors.forename: Robert De
authors.initials: RD
authors.lastname: Andrade
authors.forename: Oswaldo
authors.initials: O
authors.lastname: Carmona
authors.forename: Antonio
authors.initials: A
authors.lastname: Finelli
mesh_terms: D003558:Cystoscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D018570:Risk Assessment; D016896:Treatment Outcome; D001747:Urinary Bladder Fistula / Q000209:etiology / Q000601:surgery*; D014563:Urodynamics