The York-Mason Technique for Rectourethral Fistulas

Abstract

1Crippa A, Dall'Oglio MF, Nesrallah LJ, Hasegawa E, Antunes AA, and Srougi M. The York-Mason technique for rectourethral fistulas. Clinics. 2007;62(6):699-704. OBJECTIVE:Recto-urethral fistula formation following radical prostatectomy is an uncommon but potentially devastating event.There is no consensus in the literature regarding the treatment of these fistulas. We present here our experiences treating rectourethral fistulas. MATERIAL AND METHODS:We analyzed 8 cases of rectourethral fistula treated at our institution in the last seven years. Seven of the patients underwent repair of the fistula using the modified York-Mason procedure. RESULTS: The causes of the fistula were radical retropubic prostatectomy in five patients, perineal debridement of Fournier's gangrene in one, transvesical prostatectomy in one and transurethral resection of the prostate in the other patient. The most common clinical manifestation was fecaluria, present in 87.5% of the cases. The mean time elapsed between diagnosis and correction of the fistula was 29.6 (7-63) months. One spontaneous closure occurred after five months of delayed catheterization. Urinary and retrograde urethrocystography indicated the site of the fistula in 71.4% of the cases. No patient presented recurrence of the fistula after its correction with the modified York-Mason procedure. CONCLUSION: The performance of routine colostomy and cystostomy is unnecessary. The technique described by York-Mason permits easy access, reduces surgical and hospitalization times and presents low complication and morbidity rates when surgically correcting recto-urethral fistulas.

Technique de York-Mason dans le traitement des fistules

“…Il est recommandé d'utiliser un cathéter sus-pubien et une sonde urétrale, mais elle reste inefficace dans les fistules importantes 16,17 . Crippa et al ont signalé une seule guérison après drainage urinaire seul parmi les huit cas signalés 18 .…”

Outcome of a Modified York Mason Technique in Men With Iatrogenic Urethrorectal Fistula After Radical Prostatectomy

“…16 The York Mason procedure represents one surgical option for this condition. 8,10,17,18 However, only a few cases have been reported worldwide, and series are still scarce in the current literature. In this study, we present our own experience with the surgical management of iatrogenic urethrorectal fistula after radical prostatectomy with the York Mason technique.…”

Use of Computed Tomography (CT) Scanning and Colorectal New Methylene Blue Infusion in Evaluation of an English Bulldog with a Rectourethral Fistula

“…12 The diagnosis can be made by witnessing fecaluria or by using advanced diagnostic procedures. Some physicians prefer the aid of contrast cystourethrography 13,14 whereas others have reported the usefulness of CT scanning for both establishing the diagnosis and for surgical planning. 15 CT scanning for the detection of anorectal anomalies was first described in infants and has since become a valuable diagnostic tool.…”

“…16,17 To date, the most commonly utilized diagnostic techniques in people include cystourethroscopy, advanced imaging such as CT scanning or magnetic resonance imaging, and radiographic contrast imaging. [13][14][15][16][17][18][19] This report describes the successful use of CT and cystourethrography to diagnose a rectourethral fistula in an English Bulldog. Whereas cystourethrography was used to determine that a fistula was present, the exact anatomic location could not be verified.…”

“…[3][4][5][6][7][8][9][10]13,21 Ten of the 13 canine rectourethral fistulas reports included aerobic urine culture results. Aerobic culture yielded growth of !…”