Repair of rectourethral fistulas with transperineal buccal mucosa: Our experience.

Abstract

Introduction: Spontaneous closure of rectourethral fistulas (RUF), often seen after radical prostatectomy (RP), is rare, and most cases require surgical repair. In recent years, the perineal approach has become the most preferred technique. This study aimed to retrospectively present the surgical and functional results of transperineal buccal mucosal graft repair of RUFs developed after RP.

Methods: Twenty-four patients who developed RUF secondary to RP between January 2016 and May 2023 were included in the study. Our study excluded patients who had previous unsuccessful fistula treatment and received radiotherapy (RT). Transperineal RUF repair was performed with buccal mucosa graft in all patients and patient data were evaluated retrospectively.

Results: The mean surgery time was 15.3 (10-22) months after RP. The mean operation time was 110 minutes. The mean hospital stay was seven days. In 22 (91.6%) patients, the suprapubic catheter was removed in the third week. The mean followup period was 28 (4-76) months. The procedure was successful in all patients. No recurrence was observed in any patient during followup. The postoperative satisfaction of the patients was 100%.

Conclusions: Repair of RUFs secondary to RP with transperineal buccal mucosa is a surgical technique with a low complication and high success rates. This technique can be a good alternative to interposition procedures in non-complex fistulas.