Transanal endoscopic microsurgical repair of iatrogenic recto-urethral fistula.
BACKGROUND
Recto-urethral fistula formation following radical prostatectomy is an uncommon but potentially devastating event. Traditional surgery for such fistulae is technically demanding, jeopardizes continence and usually necessitates a diverting colostomy. We present the case of an iatrogenic fistula treated by a transanal endoscopic microsurgical approach, without recourse to a stoma.


METHODS
A 71-year-old man had recently undergone a radical prostatectomy, complicated by significant intra-operative haemorrhage. He subsequently developed a recto-urethral fistula, confirmed clinically and endoscopically. Due to his bleeding diathesis, he was considered for, and underwent, a transanal endoscopic microsurgical (TEMS) repair.


CONCLUSIONS
TEMS is a safe and reliable minimally-invasive surgical technique for the treatment of this difficult condition.
Quinlan
M
M
Department of Colorectal Surgery, The Adelaide & Meath Hospital, Incorporating the National Children's Hospital, Ireland.
Cahill
R
R
Keane
F
F
Grainger
R
R
Butler
M
M
D000368:Aged; D001003:Anal Canal; D006801:Humans; D008297:Male; D008866:Microsurgery; D011351:Proctoscopy / Q000379:methods*; D011468:Prostatectomy / Q000009:adverse effects*; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*