Penile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy.
Radiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years post-external beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myo-cutaneuos flap closure of the perineum.
Division of Urology, Vancouver Island Health Authority, Victoria, BC;
John
J
Kinahan
Department of Radiation Oncology, BC Cancer Agency - Vancouver Island Centre, Victoria, BC;
Howard
H
Pai
Division of Laboratory Medicine and Pathology, Vancouver Island Health Authority, Victoria, BC;
Mildred
M
Martens
Division of Plastic Surgery, Vancouver Island Health Authority, Victoria, BC;
Jason
J
Gray
Division of General Surgery, Vancouver Island Health Authority, Victoria, BC;
Darren
D
Biberdorf
Division of General Surgery, Vancouver Island Health Authority, Victoria, BC; ; Division of Critical Care, Vancouver Island Health Authority, Victoria, BC.
Alex
A
Mihailovic
Division of Urology, Vancouver Island Health Authority, Victoria, BC;
Iain
I
McAuley