[Surgical treatment of rectourinary fistulas: review of the literature].
BACKGROUND
A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation, or trauma. Retrospective studies and case reports have highlighted different approaches for surgical repair.


OBJECTIVE
The aim of this study was to review our experience with surgical management of RUF.


METHODS
MEDLINE (PubMed, Ovid) and the Cochrane Library were searched by using the terms RUFs urethrorectal fistulas, and prostatourethral-rectal fistulas.


METHODS
All studies were retrospective and in English. Of the records identified, 31 series were included.


RESULTS
Four hundred sixty-five patients were identified. Most patients underwent one of four categories of repair: transanal (4.7%), transabdominal (14.1%), transsphincteric (26.6%), and transperineal (57.6%). Tissue interposition flaps, predominantly gracilis muscle, were used in 56% of repairs. The fistula was successfully closed in 93.9% of patients.


CONCLUSIONS
Regardless of complexity, RUFs have an initial closure rate of 93.9%.
Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche - Clinica Urologica, Università degli Studi di Padova, Padova - Italy.
Alessandro
A
Crestani
Fabrizio
F
Dal Moro
D000328:Adult; D019317:Evidence-Based Medicine; D000071976:Gracilis Muscle / Q000637:transplantation; D006801:Humans; D019651:Plastic Surgery Procedures; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*