OBJECTIVE: To characterize conservative management of urorectal fistulae (URF). METHODS: URF are a recognized but rare complication of treatments for prostate and rectal cancers. URF can lead to incontinence, fecaluria, pain, urinary infection, and sepsis, and thus are usually treated surgically. We present a series of 3 patients whose complex URF were managed conservatively. Between 2004 and 2010, 43 patients were diagnosed with URF resulting from treatment for prostate or rectal cancer. All patients were evaluated and offered surgical treatment; 40 patients elected surgical therapy, and 3 patients chose conservative, nonoperative management of the URF. The primary outcome was the patient choosing or needing formal surgical URF closure. Because this was not a comparative study, no formal statistical analysis was undertaken. RESULTS: The 3 patients have been regularly monitored and have required symptomatic and episodic care. None, however, has opted for formal surgical fistula repair, and to date, all continue in conservative management of their URF. CONCLUSION: Spontaneous URF closure is uncommon and is unknown to occur in complex URF. Surgery is the mainstay of treatment. Patients should consider treatment options, potential outcomes, and their quality of life when choosing or not choosing treatment. The applicability and durability of conservative management of URF remains unclear.
OBJECTIVE: To characterize conservative management of urorectal fistulae (URF). METHODS: URF are a recognized but rare complication of treatments for prostate and rectal cancers. URF can lead to incontinence, fecaluria, pain, urinary infection, and sepsis, and thus are usually treated surgically. We present a series of 3 patients whose complex URF were managed conservatively. Between 2004 and 2010, 43 patients were diagnosed with URF resulting from treatment for prostate or rectal cancer. All patients were evaluated and offered surgical treatment; 40 patients elected surgical therapy, and 3 patients chose conservative, nonoperative management of the URF. The primary outcome was the patient choosing or needing formal surgical URF closure. Because this was not a comparative study, no formal statistical analysis was undertaken. RESULTS: The 3 patients have been regularly monitored and have required symptomatic and episodic care. None, however, has opted for formal surgical fistula repair, and to date, all continue in conservative management of their URF. CONCLUSION: Spontaneous URF closure is uncommon and is unknown to occur in complex URF. Surgery is the mainstay of treatment. Patients should consider treatment options, potential outcomes, and their quality of life when choosing or not choosing treatment. The applicability and durability of conservative management of URF remains unclear.
Authors: Javier C Angulo; Ignacio Arance; Yannick Apesteguy; João Felicio; Natália Martins; Francisco E Martins Journal: Int Braz J Urol Date: 2021 Mar-Apr Impact factor: 1.541
Authors: Ana Myriam Lavín-Pérez; Daniel Collado-Mateo; Xián Mayo; Gary Liguori; Liam Humphreys; Robert James Copeland; Alfonso Jiménez Journal: Sci Rep Date: 2021-07-23 Impact factor: 4.379