Acquired recto-urethral fistula in children: Long-term follow-up

Abstract

Acquired recto-urethral fistula is an uncommon entity in children and occurs as a consequence of pelvic disorder, including trauma, iatrogenic injury, inflammatory bowel disease, pelvic neoplasm and infection. We have reviewed our experience with treatment of recto-urethral fistula and focussed on the outcome of the repair. Data collected included demographics, cause, procedure type, presentation, operative details and morbidity. Telephonic and personal contact were made to evaluate functional outcome and quality of life. Between 1991 and 2008, 17 children with a mean age of 7 years were treated for recto-urethral fistula. Fifteen cases were of iatrogenic origin and two were following road traffic accident. Six underwent repair through the York-Mason approach; the remaining 11 were treated via the transperineal approach with interposition of vascularised tunica vaginalis flap. Operating time, success rate and overall satisfaction score were similar for the two groups. Both approaches used were effective to treat recto-urethral fistula. Successful repair can be achieved with minimal morbidity, short hospital stay, and good postoperative outcome and quality of life.