Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 27 June 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Surgical management of complex rectourethral fistulas

A study in the latest issue of the Diseases of the Colon & Rectum evaluates the surgical management of complex rectourethral fistulas in irradiated and nonirradiated patients.

News image

Rectourethral fistulas are an uncommon, yet devastating occurrence after treatment for prostate cancer or trauma, and their surgical management has historically been nonstandardized.

Anecdotally, irradiated rectourethral fistulas portend a worse prognosis.

Dr Jennifer Hanna and colleagues reviewed outcomes after surgical treatment of rectourethral fistulas in radiated and nonirradiated patients to construct a logical surgical algorithm.

The researchers performed a retrospective review of all patients presenting to Duke University with the diagnosis of rectourethral fistula from 1996 to 2012.

The team identified 37 patients that presented with and were treated for rectourethral fistulas.

Only 55% of irradiated patients had their ostomy reversed
Diseases of the Colon & Rectum

Of these, 21 received radiation, and a rectourethral fistula from trauma or iatrogenic injury developed in 16.

The groups were compared regarding their functional outcomes, including healing, time to healing, continence, and recurrence.

The researchers found no significant differences in patient characteristics between groups.

The team noted that patients who had irradiated rectourethral fistulas had a significantly higher rate of passage of urine through the rectum and wound infections, a higher rate of crystalloid infusion and blood transfusion requirements, and a longer time to ostomy reversal than nonirradiated patients.

Patients who had irradiated rectourethral fistulas underwent more complex operative repairs, including gracilis interposition flaps, and pelvic exenterations, whereas nonirradiated patients most commonly underwent a York-Mason repair.

The team observed no statistically significant differences in rectourethral fistula healing or in postoperative and functional outcomes.

Only 55% of irradiated patients had their ostomy reversed versus 91% in the nonirradiated group.

Dr Hanna's team concludes, "Repair of rectourethral fistulas caused by radiation has a significantly higher wound infection rate and median time to healing, and lower overall stomal reversal rate than nonradiation-induced rectourethral fistulas."

"Patients who had irradiated rectourethral fistulas required significantly more complex operations, likely contributing to the higher morbidity, mortality, and lower fistula closure rate."

"We propose an algorithm for approaching rectourethral fistulas based on etiology."

Dis Colon Rectum 2014: 57(9): 1105–1112
25 August 2014

Go to top of page Email this page Email this page to a colleague

 27 June 2016 
Epidemiology of NAFLD
 27 June 2016 
Tobacco smoking and ulcerative colitis
 27 June 2016 
The Toronto Consensus for H. pylori treatment
 24 June 2016 
Fibre for chronic idiopathic constipation
 24 June 2016 
Dietary trends in the USA
 24 June 2016 
Statins and colorectal cancer in IBD
 23 June 2016 
Adverse events after colonoscopy bowel preparations
 23 June 2016 
Touch screens in the IBD outpatient clinic
 23 June 2016 
Biomarker for eosinophilic esophagitis diagnosis
 22 June 2016 
IBS symptoms in IBD
 22 June 2016 
Benefits and harms of colorectal cancer screening
 22 June 2016 
Outcomes among US veterans with Hep B
 21 June 2016 
Screening for colorectal cancer
 21 June 2016 
Tenofovir and Hep B transmission in mothers
 21 June 2016 
Access to liver subspecialty care and survival
 20 June 2016 
Genes for colorectal cancer risk
 20 June 2016 
Patients and gastroenterologists’ perceptions on IBD
 20 June 2016 
Hep C treatment in people who inject drugs
 17 June 2016 
Noninvasive markers of liver fibrosis
 17 June 2016 
Predictors of starting with long-term PPIs
 17 June 2016 
Extrahepatic manifestations of Hep C
 16 June 2016 
Endotracheal intubation and endoscopy unit efficiency metrics
 16 June 2016 
Assessing progression of NAFLD
 16 June 2016 
Bile acid diarrhea
 15 June 2016 
Consensus for acute severe ulcerative colitis
 15 June 2016 
Dental erosions in GERD
 15 June 2016 
Pharmacological treatments for obesity with weight loss
 14 June 2016 
Antibiotics and gut inflammation
 14 June 2016 
Liver-related mortality in the developed world
 14 June 2016 
Hep C patient outcomes treated with different anti-viral regimens
 13 June 2016 
Obesity in the USA
 13 June 2016 
Celiac disease drug development
 13 June 2016 
Pneumonia risk in celiac disease
 10 June 2016 

Celiac disease drug development

 10 June 2016 
Rectal cancer surgery checklist
 10 June 2016 
Breath as a marker for IBS
 09 June 2016 
Psychological morbidity in young people with IBD
 09 June 2016 
Predicting hepatic encephalopathy in cirrhosis
 09 June 2016 
Evaluation of endoscopic findings from patients with Crohn's
 08 June 2016 
Adult obesity trends in the USA
 08 June 2016 
Pediatric IBD unclassified vs other IBD
 08 June 2016 
Dark chocolate and NASH oxidation
 07 June 2016 
Flexible endoscopy for Zenker's diverticulum
 07 June 2016 
Predicting risk of hepatic encephalopathy in cirrhosis
 07 June 2016 
Electronic learning system for colon capsule endoscopy
 06 June 2016 
Disturbed sleep and symptoms in IBS
 06 June 2016 
Oral contraceptives and Crohn’s complications
 06 June 2016 
Eosinophilic esophagitis
 03 June 2016 
Antibiotic prophylaxis in cirrhosis
 03 June 2016 
Mortality in hospitalized peptic ulcer patients
 03 June 2016 
Decision aid for surgical patients with ulcerative colitis
 02 June 2016 
Allergy tests for eosinophilic esophagitis
 02 June 2016 
Fatty liver disease and mortality
 02 June 2016 
Ethnic inequalities in rectal cancer care
 01 June 2016 
Predicting NASH resolution
 01 June 2016 
Predicting relapse in IBD
 01 June 2016 
Treatment of Hep C/HIV after liver transplant
 31 May 2016 
Markers as a reflection of inflammatory burden in ulcerative colitis
 31 May 2016 
Predicting Crohn's diseases before diagnosis
 31 May 2016 
Biomarker predicts post ERCP pancreatitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us