Rectourethral Prostatic Fistula in Males
About 80 percent of the male patients with anorectal malformations have an abnormal communication between the rectum and the urinary tract called a rectourinary fistula. The specific location of the fistula has important therapeutic and prognostic implications.
In a rectourethral prostatic fistula the rectum communicates with the upper part of the posterior portion of the urethra, passing through prostatic tissue.
The passage of meconium through the urethra follows the same pattern described for rectourethral bulbar fistula cases.
The perineum tends to be flat, with little prominence of the midline groove. A colostomy is indicated followed by a definitive repair.
The most common repair performed is the Posterior Sagittal Anorectoplasty / PSARP, which is performed on an elective basis usually within the first year of life.
It is the same procedure as described for the bulbar-urethral fistula, but the prognosis for future bowel control is not as good.
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
