We report on a quick, safe and simple procedure, the anterior perineal trans-anorectal approach, which was used successfully to treat 2 difficult cases of prostatorectal and membranous urethrorectal fistulas. This method was devised after a review of all techniques to treat these fistulas, which are known to be difficult. Our 2 cases, like others, demonstrate the harmlessness of anterior section of the anal sphincter, provided the sphincter is repaired correctly. This approach should be used in patients with urethroprostatorectal pathological conditions for whom a perineal access is contemplated.
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