Rectal flap advancement – a simple and effective approach for the treatment of rectourethral fistula

OBJECTIVE: Rectourethral fistula is a rare complication of prostatic surgery and other pelvic procedures. We report our experience of surgical repair of using a rectal advancement flap. PATIENTS: Three patients with rectourethral fistula following prostatic surgery were treated. Two patients had an anterior partial thickness of rectal flap advancement via a trans-anal approach without urinary or faecal diversion. In one patient a rectal flap repair was performed through a posterior transsphincteric approach following urinary and faecal diversion. RESULTS: No significant postoperative complications occurred. Healing was successful in each patient and faecal and urinary continence was normal. CONCLUSION: Transanal rectal advancement flap is a simple and effective technique for the treatment of a rectourethral fistula with no need for urinary or faecal diversion.