2011, Number 4
<< Back Next >>
Cir Cir 2011; 79 (4)
Interposition of gracilis muscle for rectourethral fistula repair. Case report
González-Contreras QH, Bahena-Aponte JA, Salinas-Aragón E, Jiménez-González A, González-Longoria G
Language: Spanish
References: 8
Page: 371-373
PDF size: 296.83 Kb.
ABSTRACT
Background: Rectourethral fistula is a rare disease with a difficult surgical treatment. The etiology of rectourethral fistula is iatrogenic, secondary to prostate surgery, pelvic radiotherapy and a rare complication of rectal surgery. Surgical treatment options for rectourethral fistula are diverse. Interposition of gracilis muscle has a curative index of 100% with close surveillance, as reported by Nyham.
Clinical case: We present a case of a 58-year-old male with iatrogenic rectourethral fistula secondary to radical prostatectomy and who was treated with interposition of the gracilis muscle. Eight weeks after surgery and with colostomy closed, no evidence of recurrence was detected.
Conclusions: Interposition of the gracilis muscle requires a multidisciplinary approach and demonstrates good shortterm results.
REFERENCES
Nyam DC, Pemberton JH. Management of iatrogenic rectourethral fistula. Dis Colon Rectum 1999;42:994-999.
Pickrell KL, Broadbent TR, Masters FW, Metzger JT. Construction of rectal sphincter and restoration of anal continence by transplanting the gracilis muscle: report of 4 cases in children. Ann Surg 1952;135:853-862.
González-Contreras QH, Castañeda-Argaiz R, Rodríguez-Zentner HA, Tapia-Cid de León H, Mejía-Olvalle RR, Espinosa-de los Monteros A. Interposición de músculo grácil para reparar fístulas ano y rectovaginales recurrentes. Cir Cir 2009;77:319-321.
MacRae HM. Treatment of rectovaginal fistulas that has failed previous repair attempts. Dis Colon Rectum 1995;38:921-925.
Zmora O, Tulchinsky H, Gur E, Goldman G, Klausner JM, Rabau M. Gracilis muscle transposition for fistulas between the rectum and urethra or vagina. Dis Colon Rectum 2006;49:1316-1321.
Rabau M, Zmora O, Tulchinsky H, Gur E, Goldman G. Recto-vaginal/ urethral fistula: repair with gracilis muscle transposition. Acta Chir Ugosl 2006;53:81-84.
Crippa A, Dall´Oglio MF, Nsrallah LJ, Hasegawa E, Antunes AA, Srougi M. The York–Mason technique for rectourethral fistulas. Clinics 2007;62:699-704.
Zmora O, Potente FM, Wexner SD, Pikarsky AJ, Efron JE, Nogueras JJ, et al. Gracilis muscle transposition for iatrogenic rectourethral fistula. Ann Surg 2003;237:483-487.