To fully visualize the fistula, the patient was placed into a right posterior oblique position, which showed a rectourethral fistula. As contrast was injected, a small amount began to pool over the right iliac crest in the region of the urinary bladder (Figure 6).
Typically, when the bladder is at midline, the rectovesicular or rectourethral fistula is seen extending anteriorly from the rectum.
Review of the preprocedural MRI, along with rotating the patient, helped to confirm that the pool of contrast was within the bladder and caused by the rectourethral fistula.
Rectourethral fistula: A systematic review of and experiences with various surgical treatment methods.
Management of radiotherapy induced rectourethral fistula. J Urol 2006; 175:1382-88.
Surgical management of rectourethral fistula. J Urol 2008; 71:267-71.
Functional and quality-of-life outcomes in patients undergoing transperineal repair with gracilis muscle interposition for complex rectourethral fistula. Urology 2011; 77:736-41.
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.
Use of computed tomography (CT) scanning and colorectal new methylene blue infusion in evaluation of an English Bulldog with a rectourethral fistula
. Journal of Veterinary Internal Medicine, v.23, n.4, p.931-934, jul/aug, 2009.
after combination radiotherapy for prostate cancer.
The most frequent defect in males is imperforate anus with rectourethral fistula
and in females rectovestibular defect.
Continued communication between the urogenital tract and rectal portions of the cloacal plate causes rectourethral fistulas
or rectovestibular fistulas.