TY - JOUR
T1 - Rectourethral fistula reconstruction in elderly patients
AU - Singla, Nirmish
AU - Morey, Allen F.
PY - 2015/12/29
Y1 - 2015/12/29
N2 - Purpose of review This article discusses etiologic considerations, evaluation, and contemporary approaches to managing rectourethral fistula (RUF) with particular emphasis on geriatric patients. Recent findings With the advent of multimodal approaches to treating prostate cancer, such as radiation and ablative therapies, the incidence of RUF is increasing, especially in the geriatric population. Surgical repair and healing of RUF in patients with prior radiation is more challenging than in those without prior radiation or ablation because of fibrotic and ischemic changes in surrounding tissues. There is, at present, a lack of consensus over a standardized approach to RUF management because of the heterogeneity in presentation and limited, primarily retrospective, experience in the literature. Nonetheless, an evolving array of surgical approaches now exists for fistula excision and tissue interposition. Summary Immediate recognition and management of RUF is paramount to prevent related complications. Patient selection and counseling are key to selecting the best approach for repair, whereas a multidisciplinary team, including colorectal and plastic surgery colleagues, may optimize outcomes.
AB - Purpose of review This article discusses etiologic considerations, evaluation, and contemporary approaches to managing rectourethral fistula (RUF) with particular emphasis on geriatric patients. Recent findings With the advent of multimodal approaches to treating prostate cancer, such as radiation and ablative therapies, the incidence of RUF is increasing, especially in the geriatric population. Surgical repair and healing of RUF in patients with prior radiation is more challenging than in those without prior radiation or ablation because of fibrotic and ischemic changes in surrounding tissues. There is, at present, a lack of consensus over a standardized approach to RUF management because of the heterogeneity in presentation and limited, primarily retrospective, experience in the literature. Nonetheless, an evolving array of surgical approaches now exists for fistula excision and tissue interposition. Summary Immediate recognition and management of RUF is paramount to prevent related complications. Patient selection and counseling are key to selecting the best approach for repair, whereas a multidisciplinary team, including colorectal and plastic surgery colleagues, may optimize outcomes.
KW - complications
KW - radiation
KW - reconstruction
KW - rectourethral fistula
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U2 - 10.1097/MOU.0000000000000263
DO - 10.1097/MOU.0000000000000263
M3 - Review article
C2 - 26716565
AN - SCOPUS:84952682745
SN - 0963-0643
VL - 26
SP - 171
EP - 176
JO - Current opinion in urology
JF - Current opinion in urology
IS - 2
ER -