Limits...
Rectourethral fistula: A rare complication of injection sclerotherapy.

Tanwar R, Singh SK, Pawar DS - Urol Ann (2014)

Bottom Line: The patient was successfully managed by dilatation of the stricture segment and urethral catheterization.RUF can rarely result from injection sclerotherapy and must be thoroughly evaluated.Cases which present early and have minimal contamination of urine by fecal contents can be conservatively managed with a simple Foleys catheterization for 4-6 weeks after ruling out any obstruction distal to the fistulous tract.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India.

ABSTRACT
In the modern era, the incidence of rectourethral fistula (RUF) has been on a rise due to an increasing number of surgeries being performed for prostatic carcinoma. Other causes of this condition still remain rare and their management differs from that of post prostatectomy RUF. We report a rare case of a young man who presented with leakage of urine per rectum 4 weeks after injection sclerotherapy for haemorrhoids. A Micturating Cystourethrogram/Retrograde Cystourethrogram revealed the presence of RUF arising at the level of prostrato-membranous urethra and the urine examination did not show any fecal contamination of urine. A fistula at the level or verumontanum along with stricture of the distal penile urethra was demonstrated on urethroscopy. The patient was successfully managed by dilatation of the stricture segment and urethral catheterization. RUF can rarely result from injection sclerotherapy and must be thoroughly evaluated. Cases which present early and have minimal contamination of urine by fecal contents can be conservatively managed with a simple Foleys catheterization for 4-6 weeks after ruling out any obstruction distal to the fistulous tract.

No MeSH data available.


Related in: MedlinePlus

Anal canal showing stigmata of sclerotherapy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4127870&req=5

Figure 1: Anal canal showing stigmata of sclerotherapy

Mentions: A 28-years-old gentleman presented to the out-patient department with complaints of leakage of urine per rectum while micturating, 4 weeks after injection sclerotherapy for haemorrhoids without any complaints of pneumaturia or fecaluria. Examination per rectum revealed old stigmata of sclerotherapy but no other significant findings could be appreciated on a digital rectal examination [Figure 1]. Further evaluation of the patient in the form of a Micturating Cystourethrogram/Retrograde Cystourethrogram revealed a fistulous opening connecting the prostatic urethra to the rectum [Figure 2]. Laboratory workup in the form of a complete blood count, kidney function tests, random blood sugar and serum electrolytes showed no derangement. The urine examination did not show any evidence of contamination by faecal contents on microscopic and routine examination and culture.


Rectourethral fistula: A rare complication of injection sclerotherapy.

Tanwar R, Singh SK, Pawar DS - Urol Ann (2014)

Anal canal showing stigmata of sclerotherapy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127870&req=5

Figure 1: Anal canal showing stigmata of sclerotherapy
Mentions: A 28-years-old gentleman presented to the out-patient department with complaints of leakage of urine per rectum while micturating, 4 weeks after injection sclerotherapy for haemorrhoids without any complaints of pneumaturia or fecaluria. Examination per rectum revealed old stigmata of sclerotherapy but no other significant findings could be appreciated on a digital rectal examination [Figure 1]. Further evaluation of the patient in the form of a Micturating Cystourethrogram/Retrograde Cystourethrogram revealed a fistulous opening connecting the prostatic urethra to the rectum [Figure 2]. Laboratory workup in the form of a complete blood count, kidney function tests, random blood sugar and serum electrolytes showed no derangement. The urine examination did not show any evidence of contamination by faecal contents on microscopic and routine examination and culture.

Bottom Line: The patient was successfully managed by dilatation of the stricture segment and urethral catheterization.RUF can rarely result from injection sclerotherapy and must be thoroughly evaluated.Cases which present early and have minimal contamination of urine by fecal contents can be conservatively managed with a simple Foleys catheterization for 4-6 weeks after ruling out any obstruction distal to the fistulous tract.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India.

ABSTRACT
In the modern era, the incidence of rectourethral fistula (RUF) has been on a rise due to an increasing number of surgeries being performed for prostatic carcinoma. Other causes of this condition still remain rare and their management differs from that of post prostatectomy RUF. We report a rare case of a young man who presented with leakage of urine per rectum 4 weeks after injection sclerotherapy for haemorrhoids. A Micturating Cystourethrogram/Retrograde Cystourethrogram revealed the presence of RUF arising at the level of prostrato-membranous urethra and the urine examination did not show any fecal contamination of urine. A fistula at the level or verumontanum along with stricture of the distal penile urethra was demonstrated on urethroscopy. The patient was successfully managed by dilatation of the stricture segment and urethral catheterization. RUF can rarely result from injection sclerotherapy and must be thoroughly evaluated. Cases which present early and have minimal contamination of urine by fecal contents can be conservatively managed with a simple Foleys catheterization for 4-6 weeks after ruling out any obstruction distal to the fistulous tract.

No MeSH data available.


Related in: MedlinePlus