 Preoperative voiding cystourethrogram. The bladder (B) is filled with contrast, which can be seen in the proximal urethra (U) and tracking posteriorly in the presumed pathway of the fistula ( *** ). Although a direct connection could not be seen on preoperative imaging, the trajectory implied a prostatic urethra origin. A radiopaque marker was placed at his external anal dimple (D) to provide an estimate of its location with respect to the fistula. 