Experience of using the modified transanal approach in treatment of recurrent rectourethral fistulas in children

Kyrgyzov I.V., Efremenkov A.M., Minin A.E., Sivilob D.V., Shakhbanov R.R., Shishkin I.A.

Central Clinical Hospital with Polyclinic of the Presidential Administration of the Russian Federation, Moscow, Russia

Aim. To develop surgical technique for definite treatment of recurrent rectourethral fistula in children.
Materials and methods. From 2010 to 2022, 6 children with anal atresia and recurrent rectourethral fistula after sphincteroplasty were treated. In all patients an isolation and ligation of fistula with bringing down and resection of rectum above the level of fistula using transanal access in prone position was done.
Results. The procedure was successful in all cases. Follow-up duration ranged from 4 months to 5 years. There were no complications. Sphincter function was totally preserved.
Conclusion. Novel proposed method is an effective, reliable and safe procedure to treat recurrent recto-urethral fistulas. This technique provides good view of intestine and urethra without damaging the sphincter and levator structures, and also respects the principle of separating the fistulous tract with total resection of altered segment of the intestine, which eliminates all pathogenetic mechanisms of fistula recurrence.

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About the Authors

Corresponding author: A.E. Minin – Ph.D., Pediatric urologist of the Pediatric Surgical Department of Central Clinical Hospital with Polyclinic of the Office of the President of the Russian Federation; Moscow, Russia; e-mail: dralexminin@gmail.com