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Case report
High rectourethral fistula following TURP: repair possible only after transvesical prostatectomy
  1. Shanmugasundaram Rajaian,
  2. Murugavaithianathan Pragatheeswarane,
  3. Karrthik Krishnamurthy and
  4. Lakshman Murugasen
  1. Department of Urology, MIOT International, Manapakkam, Chennai, India
  1. Correspondence to Dr Shanmugasundaram Rajaian; ssrl25{at}


We report a case of iatrogenic rectourethral fistula (RUF) in an elderly man with benign prostatic enlargement and acute urinary retention, following a transurethral resection of prostate (TURP). This patient presented a unique challenge of tackling the RUF in the presence of a large residual prostate gland and urinary tract infection. RUF was repaired only after getting the access to the fistula following transvesical prostatectomy. Follow-up imaging showed well-healed repair of RUF. Transvesical prostatectomy is a useful adjunctive procedure in repair of RUF when associated with a large prostate. This case also highlights the importance of technique selection while planning for surgery on large prostate glands. TURP is not the preferred first modality of choice for larger glands as noted in this case.

  • prostate
  • urological surgery

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  • Contributors SR and LM collected data and analysed the data along with complete patient care. PM helped in conception and design of the study. KK helped in interpretation of data and reporting .

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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

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