Abstract
Urethro-rectal fistula is a rare pathological entity, most often iatrogenic secondary to prostate surgery, or traumatic secondary to trauma of the pelvis. We report the observation of a 73-year-old patient who consults in urology for urinary discharge through the anus during urination. He is a type I diabetic patient under poorly monitored insulin, he was treated for repeated urethritis, operated 4 months ago for Fournier gangrene with the notion of traumatic urethral catheterization, he presented after the removal of the bladder catheter a dysuria with emission of urine from the anus during urination which motivated a consultation. On clinical examination, the scrotum is supple and well healed after flattening the necrotic areas; absence of cutaneous fistulous pathways; in the digital rectal examination, a small induration is found at 6 cm from the anal margin class II according to the Rivera classification, with a firm prostate of 55 g. Retrograde urethrocystography (A, B, C, D) showed the presence of a urethro-rectal fistula with the presence of multiple moniliform narrowing of the anterior urethra in favor of chronic urethritis with muscular bladder and post-voiding residue. Trans-sphincter posterior surgical procedure according to the York-Mason technique has been proposed to treat this patient.
Highlights
Copyright: Ahmed Ibrahimi et al Pan African Medical Journal (ISSN: 1937-8688)
We report the observation of a 73-year-old patient who consults in urology for urinary discharge through the anus during urination
He is a type I diabetic patient under poorly monitored insulin, he was treated for repeated urethritis, operated 4 months ago for Fournier gangrene with the notion of traumatic urethral catheterization, he presented after the removal of the bladder catheter a dysuria with emission of urine from the anus during urination which motivated a consultation
Summary
Copyright: Ahmed Ibrahimi et al Pan African Medical Journal (ISSN: 1937-8688). Cite this article: Ahmed Ibrahimi et al Fistule urétro-rectale iatrogène. &Auteur correspondant Ahmed Ibrahimi, Service dUrologie-A, Centre Hospitalo-Universitaire Ibn Sina, Faculté de Médecine et de Pharmacie, Université Mohammed V, 10000, Rabat, Maroc
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