Rectal injury in radical perineal prostatectomy.
OBJECTIVE
To report our experience in treating patients with rectal injury with radical perineal prostatectomy.


METHODS
Medical charts of 176 patients submitted to radical perineal prostatectomy from 1996 to 2005 were reviewed to identify rectal problems. A review of rectal injury in prostatectomy is provided.


RESULTS
Of 176 patients who underwent radical perineal prostatectomy, 10 (5.7%) had rectal injury and 4 (2.3%) presented rectal fistula. Two (1.1%) patients were submitted to colostomy. We discuss how to avoid and treat the complications.


CONCLUSIONS
There is a real risk of rectal injury during radical perineal prostatectomy, particularly during the learning period or if the approach is not often performed. Fistula might occur, but colostomy is actually unnecessary and rare. A better understanding of the perineal anatomy and knowledge about the technique is recommended before practicing radical perineal prostatectomy.
de Arruda
Homero Oliveira
HO
Department of Urology, São Paulo Hospital, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil. arrudas@dglnet.com.br
Cury
Jose
J
Ortiz
Valdemar
V
Srougi
Miguel
M
D000368:Aged; D003125:Colostomy; D005242:Fecal Incontinence / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D012003:Rectal Fistula / Q000209:etiology; D012007:Rectum / Q000293:injuries*; D012189:Retrospective Studies