Tube-Flap for Management of Complex Recto-Urinary Fistula with York Mason Technique : A Case Report

PRA VIT LIMKUANSUWAN, M.D., F.R.C.S. (T)*

Affiliation : *Department of Surgery, Lerdsin Hospital, Bangkok 10500, Thailand.

AbstractRecto-urinary fistula results as a complication following trauma to the penmum and pel vis. These fistulas are difficult to treat and have a high recurrence rate due to the difficult surgical approach in repairing them. Both the transabdominal or transperineal approaches used in repairing these fistulas are difficult and provide only limited exposure to the fistula being repaired. In the case report, we present a patient with complex recto-urinary fistula due to trauma to the pelvis 20 years previously. In this patient we used the transphincteric York Mason approach to directly approach the fistula, followed by construction of a tube flap connecting the bladder and the urethra. The technique is simple, easy and the outcome has been excellent after 4 years of follow-up.

Keywords : Recto-Urinary Fistula, Recto-Vesical Fistula, Recto-Urethral Fistula, Transphincteric Approach, York Mason Technique

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