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Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft
INTRODUCTION: Rectourethral fistula (RUF) is a rare major complication after radical prostatectomy (RP). Management of patients with persistent RUFs after primary repair is controversial and technically challenging. PRESENTATION OF CASE: We describe the case of a patient with history of RUF secondar...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245663/ https://www.ncbi.nlm.nih.gov/pubmed/25305599 http://dx.doi.org/10.1016/j.ijscr.2014.09.019 |
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author | Imperatore, Vittorio Creta, Massimiliano Di Meo, Sergio Buonopane, Roberto Fusco, Ferdinando Imbimbo, Ciro Longo, Nicola Mirone, Vincenzo |
author_facet | Imperatore, Vittorio Creta, Massimiliano Di Meo, Sergio Buonopane, Roberto Fusco, Ferdinando Imbimbo, Ciro Longo, Nicola Mirone, Vincenzo |
author_sort | Imperatore, Vittorio |
collection | PubMed |
description | INTRODUCTION: Rectourethral fistula (RUF) is a rare major complication after radical prostatectomy (RP). Management of patients with persistent RUFs after primary repair is controversial and technically challenging. PRESENTATION OF CASE: We describe the case of a patient with history of RUF secondary to rectal injury during laparoscopic RP and failed trans-abdominal repair. A further attempt to repair the persistent RUF was done through a perineal approach. The fistula was excised, the anterior rectal wall was closed in two layers and the defect at the level of the urethrovesical anastomosis (UVA) was repaired with an interrupted suture. A porcine dermal graft was interposed between the UVA and the rectum and was sutured to the rectal wall. There were neither clinical nor radiological evidences of fistula recurrence at one-year follow-up after transperineal surgical repair. DISCUSSION: We used, for the first time, a porcine dermal collagen allograft as interposition tissue in a persistent RUF secondary to rectal injury during laparoscopic RP. The use of this allograft allows the potential advantage of less surgical invasivity if compared to gracilis muscle graft. CONCLUSIONS: Transperineal repair of persistent RUFs with porcine dermal graft interposition is a safe and feasible surgical procedure. |
format | Online Article Text |
id | pubmed-4245663 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-42456632014-12-03 Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft Imperatore, Vittorio Creta, Massimiliano Di Meo, Sergio Buonopane, Roberto Fusco, Ferdinando Imbimbo, Ciro Longo, Nicola Mirone, Vincenzo Int J Surg Case Rep Article INTRODUCTION: Rectourethral fistula (RUF) is a rare major complication after radical prostatectomy (RP). Management of patients with persistent RUFs after primary repair is controversial and technically challenging. PRESENTATION OF CASE: We describe the case of a patient with history of RUF secondary to rectal injury during laparoscopic RP and failed trans-abdominal repair. A further attempt to repair the persistent RUF was done through a perineal approach. The fistula was excised, the anterior rectal wall was closed in two layers and the defect at the level of the urethrovesical anastomosis (UVA) was repaired with an interrupted suture. A porcine dermal graft was interposed between the UVA and the rectum and was sutured to the rectal wall. There were neither clinical nor radiological evidences of fistula recurrence at one-year follow-up after transperineal surgical repair. DISCUSSION: We used, for the first time, a porcine dermal collagen allograft as interposition tissue in a persistent RUF secondary to rectal injury during laparoscopic RP. The use of this allograft allows the potential advantage of less surgical invasivity if compared to gracilis muscle graft. CONCLUSIONS: Transperineal repair of persistent RUFs with porcine dermal graft interposition is a safe and feasible surgical procedure. Elsevier 2014-09-28 /pmc/articles/PMC4245663/ /pubmed/25305599 http://dx.doi.org/10.1016/j.ijscr.2014.09.019 Text en © 2014 The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). |
spellingShingle | Article Imperatore, Vittorio Creta, Massimiliano Di Meo, Sergio Buonopane, Roberto Fusco, Ferdinando Imbimbo, Ciro Longo, Nicola Mirone, Vincenzo Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
title | Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
title_full | Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
title_fullStr | Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
title_full_unstemmed | Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
title_short | Transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
title_sort | transperineal repair of a persistent rectourethral fistula using a porcine dermal graft |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245663/ https://www.ncbi.nlm.nih.gov/pubmed/25305599 http://dx.doi.org/10.1016/j.ijscr.2014.09.019 |
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