title: Perineal approach for rectourethral fistulae after radical laparoscopic prostatectomy.
abstract: OBJECTIVE
  To describe our experience with the perineal approach to treat rectourethral fistulae (RUF) after radical laparoscopic prostatectomy.
  
  
  METHODS
  We performed a retrospective study from 2012 to 2015 presenting 5 cases of RUF after radical laparoscopic prostatectomy. All cases required major abdominal surgery between the radical laparoscopic prostatectomy and the RUF treatment due to various complications. In no case was radiation therapy indicated prior to or after the repair. A perineal approach was performed in the 5 cases as the first option. One case required a second operation with a combined approach (abdominal and perineal) due to persistent fistulae.
  
  
  RESULTS
  After a minimum of 12 months of follow-up, 5 cases had resolved the RUF. Two patients presented urinary incontinence, and one patient had an anastomotic stricture that required internal urethrotomy. The other patients had no long-term complications.
  
  
  CONCLUSIONS
  The perineal approach provides a healthy surgical field in patients who undergo multiple operations, achieving high rates of resolution of the fistulae.
authors.affiliation: Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España. Electronic address: Jordi_guime@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Guimerà-García
authors.affiliation: Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: E
authors.initials: E
authors.lastname: Pieras-Ayala
authors.affiliation: Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: J P
authors.initials: JP
authors.lastname: Burgués-Gasion
authors.affiliation: Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: M
authors.initials: M
authors.lastname: Ozonas-Moragues
authors.affiliation: Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: V
authors.initials: V
authors.lastname: Tubau-Vidaña
authors.affiliation: Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: P
authors.initials: P
authors.lastname: Piza-Reus
mesh_terms: D000368:Aged; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010502:Perineum; D011183:Postoperative Complications / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D012003:Rectal Fistula / Q000601:surgery*; D012189:Retrospective Studies; D014522:Urethral Diseases / Q000601:surgery*; D014548:Urinary Fistula / Q000601:surgery*
keywords: Abordaje perineal; Cáncer de próstata; Fístula rectouretral; Perineal approach; Prostate cancer; Prostatectomía radical laparoscópica; Radical laparoscopic prostatectomy; Rectourethral fistulae