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Management of rectal injury and rectourinary fistula from radical prostatectomy
OBJECTIVE: This study aimed to demonstrate our management of rectal injury (RI) and rectourinary fistula (RUF) from radical prostatectomy (RP) and identify a possible factor that increased the chance of developing RUF. MATERIALS AND METHODS: Between January 2011 and December 2019, a total of 14 case...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062513/ https://www.ncbi.nlm.nih.gov/pubmed/37006220 http://dx.doi.org/10.4103/ua.ua_179_21 |
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author | Luchaichana, Nuttaphon Ramart, Patkawat |
author_facet | Luchaichana, Nuttaphon Ramart, Patkawat |
author_sort | Luchaichana, Nuttaphon |
collection | PubMed |
description | OBJECTIVE: This study aimed to demonstrate our management of rectal injury (RI) and rectourinary fistula (RUF) from radical prostatectomy (RP) and identify a possible factor that increased the chance of developing RUF. MATERIALS AND METHODS: Between January 2011 and December 2019, a total of 14 cases of RI were retrospectively reviewed and analyzed, including preoperative, perioperative, and postoperative information. RESULTS: In all 14 cases of RI, the average age at RP was 66.3 years (54–77). During the study period, 8 of 14 cases of RI occurred in our hospital, and the incidence of RI was 0.42%. RI was intraoperative recognition in 8 cases and delayed diagnosis in 6 cases. For immediate recognition, 4 of 8 cases were primarily repaired without developing RUF and did not require diverting colostomy and suprapubic cystostomy. RUF occurred in 10 cases including 4 cases of intraoperative recognition and all cases of delayed diagnosis. In a subgroup analysis of RI that occurred in our hospital, the timing for diagnosis was clinically and statistically significant difference (P = 0.029). Instantly detected RI during RP and intraoperative rectal repair resulted in no postoperative complication. Among all 10 cases of RUF, 5 cases were successfully repaired by modified York–Mason procedure with dartos tissue flap interposition. No major complications were reported. CONCLUSIONS: Incidence of RI was 0.42% and intraoperative recognition of RI was a key to prevent the development of RUF. Modified York–Mason procedure with dartos tissue flap interposition was an effective treatment for RUF. |
format | Online Article Text |
id | pubmed-10062513 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-100625132023-03-31 Management of rectal injury and rectourinary fistula from radical prostatectomy Luchaichana, Nuttaphon Ramart, Patkawat Urol Ann Original Article OBJECTIVE: This study aimed to demonstrate our management of rectal injury (RI) and rectourinary fistula (RUF) from radical prostatectomy (RP) and identify a possible factor that increased the chance of developing RUF. MATERIALS AND METHODS: Between January 2011 and December 2019, a total of 14 cases of RI were retrospectively reviewed and analyzed, including preoperative, perioperative, and postoperative information. RESULTS: In all 14 cases of RI, the average age at RP was 66.3 years (54–77). During the study period, 8 of 14 cases of RI occurred in our hospital, and the incidence of RI was 0.42%. RI was intraoperative recognition in 8 cases and delayed diagnosis in 6 cases. For immediate recognition, 4 of 8 cases were primarily repaired without developing RUF and did not require diverting colostomy and suprapubic cystostomy. RUF occurred in 10 cases including 4 cases of intraoperative recognition and all cases of delayed diagnosis. In a subgroup analysis of RI that occurred in our hospital, the timing for diagnosis was clinically and statistically significant difference (P = 0.029). Instantly detected RI during RP and intraoperative rectal repair resulted in no postoperative complication. Among all 10 cases of RUF, 5 cases were successfully repaired by modified York–Mason procedure with dartos tissue flap interposition. No major complications were reported. CONCLUSIONS: Incidence of RI was 0.42% and intraoperative recognition of RI was a key to prevent the development of RUF. Modified York–Mason procedure with dartos tissue flap interposition was an effective treatment for RUF. Wolters Kluwer - Medknow 2023 2022-11-08 /pmc/articles/PMC10062513/ /pubmed/37006220 http://dx.doi.org/10.4103/ua.ua_179_21 Text en Copyright: © 2022 Urology Annals https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Luchaichana, Nuttaphon Ramart, Patkawat Management of rectal injury and rectourinary fistula from radical prostatectomy |
title | Management of rectal injury and rectourinary fistula from radical prostatectomy |
title_full | Management of rectal injury and rectourinary fistula from radical prostatectomy |
title_fullStr | Management of rectal injury and rectourinary fistula from radical prostatectomy |
title_full_unstemmed | Management of rectal injury and rectourinary fistula from radical prostatectomy |
title_short | Management of rectal injury and rectourinary fistula from radical prostatectomy |
title_sort | management of rectal injury and rectourinary fistula from radical prostatectomy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062513/ https://www.ncbi.nlm.nih.gov/pubmed/37006220 http://dx.doi.org/10.4103/ua.ua_179_21 |
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