title: Repair of transperineal recto-urethral fistula using a fibrin sealant haemostatic patch.
abstract: OBJECTIVE
  Recto-urethral fistula (RUF) is a rare complication of radical prostatectomy. We report a transperineal approach using a fibrin sealant haemostatic patch.
  
  
  METHODS
  Five consecutive patients who developed RUF following radical prostatectomy had a direct transperineal repair with a haemostatic patch (TachoSil®) and were assessed at a median follow-up of 35.5 (21-45) months.
  
  
  RESULTS
  There were no early postoperative complications. The average length of hospital stay was 5 (4-7) days. One patient developed recurrence 4 weeks after removal of the urethral catheter. Following healing in four patients the stoma was reversed at a median interval of 3 months, and 9.5 (7-10) months following the prostatic surgery. In the four patients with successful closure there was no case of recurrence or anorectal or urinary dysfunction at a median follow-up of 35.5 (21-45) months.
  
  
  CONCLUSIONS
  Direct transperineal repair of RUF reinforced with a fibrin haemostatic patch of TachoSil is safe and effective.
authors.affiliation: Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy. giu.giuliani86@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Giuliani
authors.affiliation: Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy.
authors.forename: F
authors.identifier: http://orcid.org/0000-0003-2891-4659
authors.initials: F
authors.lastname: Guerra
authors.affiliation: Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Coletta
authors.affiliation: Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-7051-6120
authors.initials: M
authors.lastname: La Torre
authors.affiliation: Department of Obstetrics, Gynecology and Urology, 'Sapienza' University, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Franco
authors.affiliation: Department of Obstetrics, Gynecology and Urology, 'Sapienza' University, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Leonardo
authors.affiliation: Department of Surgery, Santa Maria dei Battuti Hospital, San Vito al Tagliamento, PN, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Infantino
authors.affiliation: Surgical Department, Sapienza University, Policlinico 'Umberto I', Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: La Torre
mesh_terms: D000368:Aged; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000209:etiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics
keywords: Recto-urethral fistula; TachoSil; surgery; transperineal approach