PMC4996581_01
Endoscopic ultrasound image of the fistula. The fistula tract is depicted in the 12th hour of the rectum, suggesting a suprasphincteric fistula 3 cm above the anal verge.
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However, because of his persisting symptoms the patient underwent additional imaging with anorectal endoscopic ultrasound scan, which revealed the presence of a suprasphincteric fistula 3 cm above the anal verge and at the 12th hour of the rectum, leading to the diagnosis of a rectourethral fistula (Fig. 1).
Fistula orifice right distal to the verumontanum and proximal to the striated sphincter.
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Semirigid cystourethroscopy revealed a small diverticulum on the left ureteral orifice and a fistula orifice at the 6th hour of the urethra right distal to the verumontanum and proximal to the striated sphincter (Fig. 2).