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What is a Rectourethral Fistula?

A rectourethral fistula is a rare but challenging medical condition where an abnormal connection forms between the rectum and the urethra. This leads to the unwanted transfer of bowel contents into the urinary tract, potentially resulting in urinary infections, leakage of stool through the urethra, and other complications. These fistulas can arise from various factors, including complications following surgeries on the prostate or rectum, injuries, or certain diseases like inflammatory bowel diseases.

Diagnosis

Diagnosing involves a detailed collection of the patient’s medical history and a physical examination. Specific diagnostic tests may include cystoscopy, which allows a view inside the urethra, and colonoscopy to examine the inside of the rectum. Contrast tests are often used to visualize the fistula. In some cases, magnetic resonance imaging may be required for a more detailed picture.

Treatment

Treating a rectourethral fistula often requires surgical intervention, which can be complex due to the proximity of the urinary and gastrointestinal tracts. The goal of surgical treatment is to close the fistula and restore normal function to both systems. Depending on the size and location of the fistula, as well as the patient’s overall health condition, various surgical techniques may be applied, including transabdominal, perineal, and endoscopic approaches. Postoperative recovery includes proper wound care, monitoring for potential complications, and rehabilitation.