V1877 MANAGEMENT OF RECTOURINARY FISTULA: THE YORK MASON APPROACH

Abstract

You have accessJournal of UrologyBladder Oncology & Reconstruction1 Apr 2011V1877 MANAGEMENT OF RECTOURINARY FISTULA: THE YORK MASON APPROACH Vincent Flamand, Rafael Sanchez-Salas, François Rozet, Eric Barret, Xavier Cathelineau, Marc Galiano, and Guy Vallancien Vincent FlamandVincent Flamand Lille, France More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas Paris, France More articles by this author , François RozetFrançois Rozet Paris, France More articles by this author , Eric BarretEric Barret Paris, France More articles by this author , Xavier CathelineauXavier Cathelineau Paris, France More articles by this author , Marc GalianoMarc Galiano Paris, France More articles by this author , and Guy VallancienGuy Vallancien Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1980AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The York Mason parasacrococcygeal transsphinteric approach remains one of the most suitable techniques for the treatment of rectourinary fistulas. as it provides a maximum rate of success with limited morbidity. To report current experience with the York Mason approach. METHODS 19 patients with rectourinary fistulas after radical prostatectomy (n=17) or HIFU (n=2) were treated with the York Mason operation from 1998 to 2010. All patients had a complete division of the anal sphincters and accurate suture of the divided muscle, achieving adequate restoration of the anatomical layers. The technique implied a resection of the fistula with minutely precise closure of the intestinal tract and urinary catheterization. Technique: Patient's placed in a jack-knife fashion. A paracoccigeal incision is performed and matched paired sutures placed in anal sphincter before its incision. Fistula dissection and excision is performed, then anterior rectal wall closure is closed. Finally knotting of sphincter paired sutures is done and the skin is sutured. RESULTS 19 patients have been treated with 20 months follow period and 80%, 95% and 100% rectourinary fistula resolution after 1 (n=16) , 2 (n=2) and 3 (n=1) York-Mason procedures, respectively, with 100% fecal continence. Median operative time was 70 minutes [56–150] and median blood loss 110 ml [5–600]. CONCLUSIONS Parasacrococcygeal transsphinteric approach features a high rate of resolution for rectourinary fistulas surgical treatment. The York Mason operation holds a high rate of continence with low morbidity. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e752-e753 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vincent Flamand Lille, France More articles by this author Rafael Sanchez-Salas Paris, France More articles by this author François Rozet Paris, France More articles by this author Eric Barret Paris, France More articles by this author Xavier Cathelineau Paris, France More articles by this author Marc Galiano Paris, France More articles by this author Guy Vallancien Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...