Three distinct urethral fistulae 35 years after pelvic radiation.
BACKGROUND
While the development of fistulae is a well-known complication of radiotherapy, such fistulae can often be challenging to manage.


METHODS
We describe the case of a 37 year old male who developed in succession a urethrocutaneous fistula to the thigh, a rectourethral fistula and a peritoneo-urethral fistula 35 years after radiotherapy for pediatric pelvic rhabdomyosarcoma. These complications were managed successfully after multiple surgical procedures.


CONCLUSIONS
We subsequently discuss the different approaches currently employed for the management of radiation induced urinary fistulas and describe the rationale behind our approach towards their surgical management.
Government Medical College and Hospital, Chandigarh, India.
Arindam
A
Sharma
Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Michael P
MP
Kurtz
Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Jairam R
JR
Eswara
Radiation Injuries; Rhabdomyosarcoma; Surgical Flaps; Urinary Diversion; Urinary Fistula