PMC7724097_01
CT abdomen with intravesical contrast administered via catheter, illustrates a small amount of contrast in the urinary bladder with extraluminal contrast collected in the prostate bed. This indicates a dorsal bladder wall defect, suggesting that there is an open communication between the urinary bladder and surgical bed. The arrow points to the extraluminal contrast. On the left side (transverse section), a defect of the ventral rectal wall is illustrated.
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On postoperative day (POD) 2 urinary leakage from the rectum, obvious complaints of a urinary tract infection and the results of the CT abdomen (see Fig. 1) indicated the presence of a rectovesical fistula.
Perineal incision with the pudendal thigh flap.
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PMC7724097_02_gr4.jpg
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The procedure included a debridement of the fistula tract, closure of the defects of the vesical wall (first layer) and the rectal wall (third layer) and an interposition of a pudendal thigh flap (see Fig. 4) (second layer) to reduce the possibility of recurrence (see Box 1 for a detailed step by step description). The duration of the procedure was 189 min.
PMC7724097_02
CT abdomen with intravescial contrast administered via catheter, shows a connection between the urinary bladder and the rectum, illustrating the rectovesical fistula. The arrow points out the rectovesical fistula.
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PMC7724097_02_gr2.jpg
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A CT abdomen with intravesical contrast administered via catheter confirmed a rectovesical fistula (see Fig. 2).
Perineal incision with the pudendal thigh flap.
gr4.jpg
PMC7724097_02_gr4.jpg
fig0020
The procedure included a debridement of the fistula tract, closure of the defects of the vesical wall (first layer) and the rectal wall (third layer) and an interposition of a pudendal thigh flap (see Fig. 4) (second layer) to reduce the possibility of recurrence (see Box 1 for a detailed step by step description). The duration of the procedure was 189 min.
PMC7724097_03
CT scan of the abdomen with rectal contrast shows a rectovaginal fistula. The arrow points to the rectovaginal fistula.
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A CT-scan of the abdomen confirmed a rectovaginal fistula (see Fig. 3).