Diagnosis and management of rectal injury after radical prostatectomy: clinical experience and literature review
10.3969/j.issn.1009-8291.2025.06.004
- VernacularTitle:前列腺癌根治术中直肠损伤的处理经验总结与文献回顾
- Author:
Pengyu LU
1
;
Xiang GAO
1
;
Ying KE
1
;
Bo YANG
1
Author Information
1. Department of Urology, The Second Hospital of Dalian Medical University, Dalian 116021, China
- Publication Type:Journal Article
- Keywords:
prostatic cancer;
radical prostatectomy;
rectal injury;
rectourethral fistula
- From:
Journal of Modern Urology
2025;30(6):476-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To summarize the clinical characteristics, diagnosis, treatment and outcomes of rectal injury (RI) occurring after radical prostatectomy (RP). Methods: The clinical data of 513 patients with prostatic cancer undergoing RP in our hospital during Mar.2013 and Oct.2022 were retrospectively collected and statistical description of the occurrence of RI among them was conducted.There were a total of 7 patients with RI during operation and 1 progressed to rectourethral fistula (RUF).We summarized the clinical and pathological data of these 7 patients.The treatment strategies of RI/RUF after RP in 11 different centers were explored and summarized in combination with literature review. Results: Among the 7 RI patients, 6 developed RI during operation and healed after repair, while 1 progressed to RUF after operation.For this patient, conservative treatment failed and colostomy was performed along with bilateral ureteral stent placement and cystostomy.The RUF was repaired via the transanal approach.During the treatment process, recurrent and refractory bladder irritation symptoms and bladder spasms occurred.Data of 3203 patients who underwent RP in 11 different centers were collected; 56(1.75%) cases developed RI, 41 of which were detected and repaired during operation; 14(0.44%) developed RUF, 7 of which had fistula closed spontaneously and 7 received surgical repair. Conclusion: RI, especially RUF, is one of the rarest and severest complications after RP.Once RI is detected during operation, immediate and thorough two-layer suture repair should be performed.
