title: Rectal injury in radical perineal prostatectomy.
abstract: 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.
authors.affiliation: Department of Urology, São Paulo Hospital, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil. arrudas@dglnet.com.br
authors.forename: Homero Oliveira
authors.initials: HO
authors.lastname: de Arruda
authors.forename: Jose
authors.initials: J
authors.lastname: Cury
authors.forename: Valdemar
authors.initials: V
authors.lastname: Ortiz
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: 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