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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...

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Autores principales: Luchaichana, Nuttaphon, Ramart, Patkawat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
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.
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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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