title: ENDOSCOPIC SHIELDING OF RECTOURETHRAL FISTULA AFTER LAPAROSCOPIC RADICAL PROSTATECTOMY; REPORT OF A CASE.
abstract: Rectourethral fistulais a relatively rare complication of radical prostatectomy but is extremely difficult to treat. We report a case with post-laparoscopic radical prostatectomy rectourethral fistula, treated with only endoscopic shielding.A 75-year-old man had undergone laparoscopic radical prostatectomy for prostate cancer, cT2cN0M0. Although there was no finding of rectal injury during the operation, pneumaturia, pyuria and diarrhea appeared at postoperative day 21 and diagnosed rectourethral fistula by colonoscopy and amidotrizoic acid enema. The fistula did not close spontaneously. Four months after the prostatectomy, we treated with endoscopic shielding by use of polyglycolic acid sheets and fibrin glue. The fistula have not recurred for 20 months after the endoscopic procedure.This method is simple and less-invasive for patients. We think it is worth trying this method before surgical management for narrow rectourethral fistula following radical prostatectomy.
authors.affiliation: Department of Urology, Uji-Tokusyukai Medical Center.
authors.forename: Takuto
authors.initials: T
authors.lastname: Kusaba
authors.forename: Takashi
authors.initials: T
authors.lastname: Osafune
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nagasawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Sekioka
authors.forename: Kengo
authors.initials: K
authors.lastname: Takimoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Narita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011100:Polyglycolic Acid / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012003:Rectal Fistula / Q000628:therapy*; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000628:therapy*; D014548:Urinary Fistula / Q000628:therapy*
chemical_list: D015718:Fibrin Tissue Adhesive; D011100:Polyglycolic Acid