[Surgical treatment of rectourinary fistulas: review of the literature]

BACKGROUND: A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation, or trauma. Retrospective studies and case reports have highlighted different approaches for surgical repair.OBJECTIVE: The aim of this study was to review our experience with surgical management of RUF.DATA SOURCES: MEDLINE (PubMed, Ovid) and the Cochrane Library were searched by using the terms RUFs urethrorectal fistulas, and prostatourethral-rectal fistulas.STUDY SELECTION: All studies were retrospective and in English. Of the records identified, 31 series were included.RESULTS: Four hundred sixty-five patients were identified. Most patients underwent one of four categories of repair: transanal (4.7%), transabdominal (14.1%), transsphincteric (26.6%), and transperineal (57.6%). Tissue interposition flaps, predominantly gracilis muscle, were used in 56% of repairs. The fistula was successfully closed in 93.9% of patients.CONCLUSIONS: Regardless of complexity, RUFs have an initial closure rate of 93.9%.