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

Fistula tract seen at the level of verumontanum on urethroscopy
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Fistula tract seen at the level of verumontanum on urethroscopy

Mentions: A urethroscopy was done to demonstrate the fistula and revealed a stricture in the distal penile urethra along with a fistulous communication with the rectum at the level of verumontanum in the prostatic urethra [Figure 3]. The bladder was grossly normal. The stricture segment was dilated using serial plastic dilators passed over a 0.035 inch guidewire. A Foleys catheter with its distal most end cut, was glided over the guidewire into the bladder and inflated. The patient was followed up on a biweekly basis in the out-patient department. Patient's symptoms improved on bypassing the fistula and the tract gradually healed over a period of 4 weeks after which the Foleys catheter was removed. The patient did not have any complaints at 3 months of follow-up.


Rectourethral fistula: A rare complication of injection sclerotherapy.

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

Fistula tract seen at the level of verumontanum on urethroscopy
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Fistula tract seen at the level of verumontanum on urethroscopy
Mentions: A urethroscopy was done to demonstrate the fistula and revealed a stricture in the distal penile urethra along with a fistulous communication with the rectum at the level of verumontanum in the prostatic urethra [Figure 3]. The bladder was grossly normal. The stricture segment was dilated using serial plastic dilators passed over a 0.035 inch guidewire. A Foleys catheter with its distal most end cut, was glided over the guidewire into the bladder and inflated. The patient was followed up on a biweekly basis in the out-patient department. Patient's symptoms improved on bypassing the fistula and the tract gradually healed over a period of 4 weeks after which the Foleys catheter was removed. The patient did not have any complaints at 3 months of follow-up.

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