Rectourethral Fistula Repair: What to Know

About this video

A rectourethral fistula is an abnormal connection between the rectum and the urethra, most often after treatment for prostate cancer. Dr. Alex Vanni explains why a fistula matters, how the repair is planned, how the operation is done, the results with and without prior radiation, more complex fistulas involving the pubic bone, and what recovery looks like.

Key points

• A rectourethral fistula is an abnormal connection between the rectum and the urethra
• Most develop after prostate or rectal surgery, radiation, or other energy-based treatment
• Preparation may include a temporary colostomy, hyperbaric oxygen after radiation, and nutrition support
• The transperineal repair separates and closes the rectum and urethra, often with a gracilis muscle flap
• The fistula closes in about 98% of men without radiation and about 86% after radiation
• Fistulas involving the pubic bone often require removing the bladder and infected bone, with an ileal conduit

Chapters

1. 0:00Introduction
2. 0:23Why It Matters
3. 0:59Planning the Repair
4. 1:41The Operation
5. 2:17Results
6. 2:52Recovery