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CASE REPORT
Unexpected complication after radical (inguinal) orchidectomy: trans-sphincteric anoscrotal fistula
  1. Amit Patel1,
  2. Chris Gillespie2,
  3. Anthony J Kiosoglous1,3
  1. 1Department of Urology, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia
  2. 2Department of General Surgery, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia
  3. 3University of Queensland, School of Medicine and Surgery, Brisbane, Australia
  1. Correspondence to Dr Amit Patel, amitpatel86{at}gmail.com

Summary

Anoscrotal fistula is an extremely rare condition involving an epithelialised tract between the anal canal and scrotal wall. It is more commonly seen as a congenital phenomenon in the paediatric population, and has not previously been described in the literature in adults. We present the case of a man aged 52 years who developed a complex anoscrotal fistula after a radical inguinal orchidectomy for an intratesticular seminoma. A postsurgical wound-site infection developed into a chronically discharging wound refractory to antibiotic treatment prompting further investigation. By way of MRI, a 10 cm long trans-sphincteric anoscrotal fistula was found. The patient was successfully treated by fistuloscopic curettage, internal closure using an Ovesco clip, and negative pressure dressing. We present for the first time a rare anoscrotal fistula in an adult.

https://doi.org/10.1136/bcr-2016-218078

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    Footnotes

    • Contributors AP is part of the treating team for this patient's urological condition. He was instrumental in study design, acquisition of data, data analysis and interpretation. He drafted the article and revised it critically for important intellectual content. He prepared and approved the final version published. CG is the treating colorectal surgeon, managing the fistula. He was also involving in critically revising the manuscript, and approved the final version. AJK is the treating urologist who initially treated the patient. He conceived and designed the study. He critically revised the manuscript, and approved the final version. All authors are in agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.