PMC3196981_01
Rectourinary fistula after LRP. The retrograde cystourethrography shows the filling of the bladder and the contrast in the rectum.
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fig1
The digital rectal examination revealed no alterations, and the retrograde cystourethrography showed the contrast passing to the rectum (Figure 1).
Prone position:Jack-Knife position.
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fig2
The patient is placed in prone position:Jack-Knife position:and buttocks kept away with adhesive (Figure 2).
The surgical incision of York:Mason technique:starting at the right side of the coccyx towards the anal edge by the midline.
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fig3
The incision starts at the right edge of the coccyx and extends to the midline to the anal edge (Figure 3).
Diagram of the York-Mason technique (from Middleton RG: rectourethral fistula repair. In Krane RJ, Siroky MB, Fitzpatrick JM, eds: Operative Urology. Philadelphia, Churchill-Livingstone, 2000:286).
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fig4
In this case, we did not do the excision of the fistulous track because of the proximity of the ureteral meatus (Figures 4, 5, and 6).
Dissection and identification of the fistulous track, respectively.
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fig5
In this case, we did not do the excision of the fistulous track because of the proximity of the ureteral meatus (Figures 4, 5, and 6).
Dissection and identification of the fistulous track, respectively.
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fig6
In this case, we did not do the excision of the fistulous track because of the proximity of the ureteral meatus (Figures 4, 5, and 6).