title: Unexpected complication after radical (inguinal) orchidectomy: trans-sphincteric anoscrotal fistula.
abstract: Anoscrotal fistula is an extremely rare condition involving an epithelialised tract between the anal canal and scrotal wall. It is more commonly seen as a congenital phenomenon in the paediatric population, and has not previously been described in the literature in adults. We present the case of a man aged 52 years who developed a complex anoscrotal fistula after a radical inguinal orchidectomy for an intratesticular seminoma. A postsurgical wound-site infection developed into a chronically discharging wound refractory to antibiotic treatment prompting further investigation. By way of MRI, a 10 cm long trans-sphincteric anoscrotal fistula was found. The patient was successfully treated by fistuloscopic curettage, internal closure using an Ovesco clip, and negative pressure dressing. We present for the first time a rare anoscrotal fistula in an adult.
authors.affiliation: Department of Urology, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia.
authors.forename: Amit
authors.identifier: http://orcid.org/0000-0002-1209-3561
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of General Surgery, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Gillespie
authors.affiliation: Department of Urology, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia.|University of Queensland, School of Medicine and Surgery, Brisbane, Australia.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Kiosoglous
mesh_terms: D001004:Anus Diseases / Q000209:etiology* / Q000601:surgery; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D005832:Genital Diseases, Male / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012003:Rectal Fistula / Q000209:etiology* / Q000601:surgery; D012611:Scrotum; D013736:Testicular Neoplasms / Q000601:surgery; D016896:Treatment Outcome