Repair of transperineal recto-urethral fistula using a fibrin sealant haemostatic patch.

Aim Rectourethral fistula (RUF) is a rare complication of radical prostatectomy. We report a trans-perineal approach using a fibrin sealant haemostatic patch. Method Five consecutive patients who developed RUF following radical prostatectomy had a direct transperineal repair with a haemostatic patch (TachoSil®) and were assessed at a median follow up of 35.5 (21-45) months. Results There were no early postoperative complications. The average length of hospital stay was 5 (4-7) days. One patient developed recurrence four weeks after removal of the urethral catheter. Following healing in four patients the stoma was reversed at a median interval of three months, and 9.5 (7-10) months following the prostatic surgery. In the four patients with successful closure there was no case of recurrence or anorectal or urinary dysfunction at a median follow-up of 35.5 (21-45) months,. Conclusion Direct transperineal repair of rectourethral fistula reinforced with a fibrin haemostatic patch of TachoSil® is safe and effective. This article is protected by copyright. All rights reserved.