The York Mason approach to repair of iatrogenic rectourinary fistulae

BACKGROUND: We report our experience of 8 patients who underwent repair of iatrogenic rectourinary fistulae via the transsphincteric (York Mason) approach. PATIENTS AND METHODS: Eight patients developed rectourinary fistulae in the course of treatment of prostate cancer. Three fistulae developed after radiation therapy alone, three after prostatectomy, and two after both surgery and radiation therapy. Five patients underwent fecal diversion in conjunction with repair. RESULTS: All fistulae remained closed after repair. All patients were continent of stool after primary surgery or after colostomy closure if they had been diverted. Two patients had complications associated with urethral catheters that resolved with changing the catheters. CONCLUSION: The transsphincteric (York Mason) approach in the repair of rectourinary fistulae results in successful closure of the fistulae without impairment of continence to stool. This procedure is much simpler than complicated transabdominal or transperineal approaches to these fistulae. (C) 1997 by Excerpta Medica, Inc.