TY - JOUR
TI - Unusual Case of Urethrorectal Fistula in Adolescence in a Patient with a History of Congenital Anorectal Malformation.
AU - Nastos, Constantinos
AU - Sotirova, Ira
AU - Papatsoris, Athanasios
AU - Skolarikos, Andreas
AU - Papaconstantinou, Ioannis
AU - Dellis, Athanasios
JO - Journal of Endourology Case Reports
PY - 2016
VL - 2
TODO - 1
SP - 24--26
PB - 
SN - null
TODO - 10.1089/cren.2015.0042
TODO - null
TODO - BACKGROUND: Urethrorectal fistula is a rare and debilitating condition. Spontaneous closure is rarely effective, and appropriate management regarding timing of repair  and surgical approach remains controversial. CASE PRESENTATION: We present a case of  an 18-year-old male found to have a urethrorectal fistula after diagnostic work up  for unejaculation. The patient gradually developed recurrent urinary tract  infections and urine and semen leak from his rectum. He had a medical history of an  anorectal reconstruction in the second postnatal day due to an anorectal  malformation. Imaging with a rectal endoscopic ultrasound scan revealed a  suprasphincteric urethrorectal fistula that was further confirmed with semirigid  urethrocystoscopy and placement of a nitinol guidewire through the urethral fistula  orifice. Its anal orifice was 3 cm above the anal verge at the 12th hour of the  rectum. The fistula orifice on the rectum was identified with a transanal approach  and the fistula was managed with the performance of an advancement mucosal flap and  bladder catheterization. The patient developed a recurrence with this approach and  finally underwent fistula ligation and reconstruction using a scrotal flap. The  patient has not had a recurrence of the fistula during his follow-up. CONCLUSION:  This is an unusual case of iatrogenic urethrorectal fistula as it presented in  adolescence many years from the initial operation of anorectal reconstruction and  with unusual symptoms.
ER -