Rectoprostatic Urethral Fistula
Bulbar Fistula Repair
|
The surgical technique, called Posterior Sagittal Anorectoplasty / PSARP described for bulbar fistula is basically the same one used for the repair of rectoprostatic urethral fistula.
In those cases, however, bear in mind that the chances of finding more underdeveloped muscles are higher.
Once the levator muscle is opened, the rectum usually does not bulge so much as in the urethral bulbar fistula.
The amount of rectal dissection required is usually more extensive, which lengthens the time of the procedure. Many times it is possible to see the rectum passing through the prostatic tissue itself.
The more dissection the rectum requires, the more chance there is of devitalizing and devascularizing the rectum and it is not unusual to see, in a case of high prostatic fistula, a cyanotic dusky rectum at the end of the procedure.
In spite of that, we have observed that the intramural blood supply of the intestine in this area is very good, and so far, a case of ischemic retraction of the rectum has not occurred in our hands.
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
