Article Text

Download PDFPDF
Rectourethral fistula following focal irreversible electroporation for prostate cancer
  1. Sean Ong1,2,
  2. Zein Alhamdani3 and
  3. Nathan Lawrentschuk2,4
  1. 1EJ Whitten Foundation Prostate Cancer Research Centre at Epworth, Richmond, Victoria, Australia
  2. 2Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
  3. 3Department of Urology, Austin Health, Heidelberg, Victoria, Australia
  4. 4Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
  1. Correspondence to Dr Sean Ong; ongxrs{at}gmail.com

Abstract

A man in his 50s presented 4-week postirreversible electroporation (IRE) for low-to-intermediate risk prostate cancer with urinary symptoms, diarrhoea and passing fluid per rectum when urinating. Urine microscopy and sensitivities showed raised leucocytes, erythrocytes and pansensitive Escherichia coli. A CT cystogram revealed a rectourethral fistula (RUF). Urinary diversion with insertion of an indwelling catheter for 6 weeks was performed. A rigid cystoscopy 6 weeks after urinary diversion revealed that the fistula was still present, confirmed by intraoperative contrast. The fistula was repaired with diathermy and a fibrin glue. The patient reported resolution of urinary and bowel symptoms. This is the first case report in the literature of an RUF following IRE for prostate cancer. It is important to report these rare complications as novel treatments become more common across the world.Background

  • Prostate
  • Urological surgery
  • Surgical oncology
  • Prostate Cancer

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Twitter @_SeanOng

  • Contributors SO and ZA and NL were involved in the conception and design of the report. SO and NL acquired and interpreted the data. SO and ZA planned and created the manuscript and video.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.