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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}


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

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  • 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.

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