Areas of Expertise
About Rectourethral Fistula
Fistulas are abnormal connections between two structures. Most commonly, they involve an area of the rectum or anus to an associated structure surrounding the anus. A rectouretral fistula is a connection between the rectum or anus and the urethra, which is the tube that empties the bladder and allows you to urinate. A fistula here may develop following surgery of the prostate, radiation to the pelvis for prostate, rectal, or cervical cancer, or for other reasons.
Intestinal fistulas often present with urinary complaints. Patients express air, gas bubbles, or stool when they urinate. They may have recurrent urinary tract infections, have pain in the area, or leak urine in the stool.
Diagnosis usually requires either direct visualization of the connection (with a scope or colonoscopy), by injection of radiologic contrast into the area, or by visual examination of the bladder and associated tubes. This requires evaluation by a professional who can sort out all of these symptoms.
Treatment for Fistulas:
Fistula treatment can be difficult, especially in cases of prior radiation for cancer. Radiation causes damage to the tissue, and any attempt at surgery often does not heal properly. There are a number of surgical approaches to the treatment of rectourethral fistulas that may involve extensive reconstruction of the area. To promote healing, these surgeries may require a temporary diverting colostomy bag or stoma. This diverts feces away from the area while the tissues heal. While this may be temporary, in cases of difficult to treat fistulas, it may be the only permanent solution. Talk to your specialist to learn more about this disease process.