PI-01 RECTOURETHRAL FISTULAS SECONDARY TO PROSTATE CANCER TREATMENT: MANAGEMENT AND OUTCOMES

Abstract

You have accessJournal of UrologyPlenary Session I - Best Abstracts1 Apr 2015PI-01 RECTOURETHRAL FISTULAS SECONDARY TO PROSTATE CANCER TREATMENT: MANAGEMENT AND OUTCOMES Catherine Harris, Benjamin Breyer, Ramon Virasoro, Alex Vanni, Daniela Andrich, Gerald Jordan, Leonard Zinman, Anthony Mundy, and Jack McAninch Catherine HarrisCatherine Harris More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , Ramon VirasoroRamon Virasoro More articles by this author , Alex VanniAlex Vanni More articles by this author , Daniela AndrichDaniela Andrich More articles by this author , Gerald JordanGerald Jordan More articles by this author , Leonard ZinmanLeonard Zinman More articles by this author , Anthony MundyAnthony Mundy More articles by this author , and Jack McAninchJack McAninch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2900AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Rectourethral fistula is a known complication of prostate cancer treatment. Reports in the literature on technique and outcomes of RUF repair are limited to case reports and single surgeon case series. We aim to examine variations in techniques and outcomes of RUF repair in a multi-institutional setting. METHODS We retrospectively identified patients who underwent rectourethral fistula repair after prostate cancer treatment from four reconstructive centers of excellence (University College London Hospitals; University of California, San Francisco; Lahey Clinic; Devine-Jordan Center for Reconstructive Surgery and Pelvic Health) over a 15-year period. We examined the type(s) of prostate cancer treatment, method of fistula repair, outcomes, and need for subsequent procedures. RESULTS 201 patients underwent rectourethral fistula repair following prostate cancer treatment with an overall success rate of 91.5% (184). 97 (48.2%) fistulas occurred after radical prostatectomy alone, and 104 (51.8%) had some form of radiation/ablative treatment. Of the radiation/ablative patients, 85 patients (42.3%) had radiation/ablation treatment only, and 19 (9.5%) had both surgery and radiation/ablation. 155 (73%) patients had a bowel diversion prior to or at the time of fistula repair, and this was similar in both surgical and radiation/ablation fistula groups. More patients with radiation/ablation fistulas had placement of an interposition flap or graft at the time of fistula repair (91% vs 53%). 40 (19%) patients had a concomitant bladder neck contracture or urethral stricture identified and repaired at the time of fistula repair. 12 (5.6%) patients underwent salvage fistula repair. 3 (1.4%) ultimately underwent a permanent urinary diversion. 24 (11%) patients required placement of an artificial urinary sphincter. CONCLUSIONS Rectourethral fistulas occurring from prostate cancer therapy can be reconstructed successfully in a high percentage of patients, avoiding permanent urinary diversion in these complex cases. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e408 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Catherine Harris More articles by this author Benjamin Breyer More articles by this author Ramon Virasoro More articles by this author Alex Vanni More articles by this author Daniela Andrich More articles by this author Gerald Jordan More articles by this author Leonard Zinman More articles by this author Anthony Mundy More articles by this author Jack McAninch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...