Seminal vesicle‐rectal fistula: A review of an unusual complication following low anterior resection for rectal cancer

Abstract

Low anterior resection is the most common operation in the USA for low rectal cancers. Seminal vesicle-rectal (SV-R) fistula is an extremely uncommon complication of this operation. The objective of the present literature review was to investigate risk factors that lead to the development of SV-R fistula, clinical presentation, investigation and management options. There were nine articles of relevance which reported a total of 12 cases of SV-R fistula. All other iatrogenic or cryptogenic fistula were excluded. Twelve cases were identified in the literature, and we describe one further case. Pneumaturia and fever were presenting symptoms in 10 of 13 cases; 69.2 per cent (n = 9) of cases presented within 2 weeks of the procedure. Computed tomography was the investigation of choice in nine of 13 cases. A variety of surgical and conservative management plans were utilized. Conservative management was successful in 46.1 per cent (n = 6) of cases. The present study provides the first concise review of SV-R fistula following low anterior resection and adds a further case. It is also the first article of its kind to recommend a treatment algorithm that consists of a trial of conservative management.