Use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula

Purpose To report the author’s experience on a mini-invasive technique using bioprosthetic plug and a rectal wall flap advancement in the treatment of recurrent recto-urethral fistula. Materials and methods Between 2013 and 2015, seven patients with recurrent recto-urethral fistula were referred to...

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Bibliographic Details
Published in:International urology and nephrology 2017-09, Vol.49 (9), p.1605-1609
Main Authors: Moretto, G., Casaril, A., Inama, M.
Format: Article
Language:English
Subjects:
Biological Products - therapeutic use
Blood Loss, Surgical
Cancer surgery
Fistulae
Humans
Length of Stay
Medicine
Medicine & Public Health
Migration
Minimally Invasive Surgical Procedures - instrumentation
Minimally Invasive Surgical Procedures - methods
Nephrology
Operative Time
Prostate cancer
Rectal Fistula - surgery
Rectum
Recurrence
Retreatment - instrumentation
Retreatment - methods
Surgical Flaps
Surgical Mesh
Urethral Diseases - surgery
Urinary Fistula - surgery
Urinary incontinence
Urological surgery
Urology
Urology - Original Paper
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Summary:Purpose To report the author’s experience on a mini-invasive technique using bioprosthetic plug and a rectal wall flap advancement in the treatment of recurrent recto-urethral fistula. Materials and methods Between 2013 and 2015, seven patients with recurrent recto-urethral fistula were referred to the Pederzoli Hospital, Peschiera del Garda, Verona, Italy. Intraoperatively all patients were found to have a rectal wall lesion and were treated with urinary and fecal diversion. For the persistence of the fistula, all the patients underwent a mini-invasive treatment consisting on placement of a bioprosthetic plug in the fistula covered by an endorectal advancement flap through a trans-anal and trans-urethral combined technique. Results Median operative time was 48 min with a median blood loss of 30 ml. Median hospital stay was 3 days (IQR 1–3). No case of fistula recurrence or plug migration was described. None of the patients experienced fecal or urinary incontinence. All patients obtained complete fistula healing. Conclusions Recurrent recto-urethral fistula is a challenging postsurgical complication for surgeons and urologists, and its best treatment is still unknown. Our method seems to be feasible and effective for the treatment of complex recto-urethral fistula.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-017-1652-5