Research & Publications

Objectives To present our experience and outcomes in the surgical management of rectourethral fistula (RUF). Materials and methods We retrospectively analysed data from 11 patients treated for RUF between 2015 and 2024. Patient demographics, aetiology, fistula complexity, surgical approach, and outcomes were reviewed. Results The mean patient age was 29 years (range = 18–62). In 81% of cases, RUF resulted from road traffic accidents, and four patients had previously failed repairs. All patients underwent suprapubic catheter placement and faecal diversion before definitive surgery. Seven patients (63.6%) had a complex fistulas, while four had simple ones. The perineal approach was used in eight patients (72.7%), with a transpubic in two patients (18.18%) and cystectomy with ileal conduit diversion in one patient (9%). The gracilis muscle interposition flap was used in most cases. At a 1-year follow-up, no patients experienced per rectal leakage, and 81% had catheter removal by 3 months. Conclusion Our study demonstrates that with thorough evaluation and proper management, RUF closure rates can reach up to 100%. The pedicled gracilis muscle flap is highly effective for interposition in complex cases.