They reported that 7% of patients (n=4) experienced serious adverse effects, including osteitis pubis, necrosis of the trigone and genesis of rectourethral
Zmora, "Gracilis muscle interposition for the treatment of rectourethral
, rectovaginal, and pouch-vaginal fistulas: results in 53 patients," Annals of Surgery, vol.
Local progression may cause invasion of adjacent structures leading to pain, urinary retention due to invasion of the bladder and/or urethra, obstruction of the rectum, establishment of rectourethral
or rectovesical fistulas, and infiltration of the pelvic nerve bundles.
Continued communication between the urogenital tract and rectal portions of the cloacal plate causes rectourethral
fistulas or rectovestibular fistulas.
To fully visualize the fistula, the patient was placed into a right posterior oblique position, which showed a rectourethral
The formation of rectourethral
fistula/fibrosis can occur in 1%  of patients undergoing primary HIFU therapy causing compromised blood supply and poor tissue quality .
With the increasing use of external beam radiation and brachytherapy in management of localized prostate cancer, radiation-induced rectourethral
fistulas have become a significant clinical problem.
Experience with 30 posttraumatic rectourethral
fistulas: presentation of posterior transsphincteric anterior rectal wall advancement.
Following the removal of the urethra, the rectourethral
fibers, vas deferens, and seminal vesicles were dissected.
Adverse events included bladder neck/urethral stenosis/stricture (2-17%), prolonged urinary retention (3-14%), urinary tract infection (2-58%), urinary incontinence (2-34%), rectal burns (0-15%), and rectourethral
fistula (0-3%) .
fistula after combination radiotherapy for prostate cancer.
A grade 3b complication occurred in 26 patients who had bladder outlet obstruction or urethral stricture managed by optical urethrotomy and in one man (0.9%) who had developed a rectourethral
fistula managed surgically.