Outcomes after recto-anastomosis fistula repair in patients who underwent radical prostatectomy for prostate cancer
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Outcomes after recto-anastomosis fistula repair in patients who underwent radical prostatectomy for prostate cancer. / Pfalzgraf, Daniel; Isbarn, Hendrik; Reiss, Philip; Meyer-Moldenhauer, Wolf-Hartmut; Fisch, Margit; Dahlem, Roland.
in: BJU INT, Jahrgang 113, Nr. 4, 01.04.2014, S. 568-573.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Outcomes after recto-anastomosis fistula repair in patients who underwent radical prostatectomy for prostate cancer
AU - Pfalzgraf, Daniel
AU - Isbarn, Hendrik
AU - Reiss, Philip
AU - Meyer-Moldenhauer, Wolf-Hartmut
AU - Fisch, Margit
AU - Dahlem, Roland
N1 - © 2013 The Authors. BJU International © 2013 BJU International.
PY - 2014/4/1
Y1 - 2014/4/1
N2 - OBJECTIVES: To assess fistula recurrence rate and health-related quality of life (HRQL) after repair, as well as the impact on continence and erection in patients with recto-anastomotic fistula after radical prostatectomy (RP). In recent publications, the numbers of cases of recto-urinary fistulae after RP are relatively small. Success rates at fistula closure are good; however, data about functional outcomes and HRQL are more restricted.PATIENTS AND METHODS: A retrospective study of patients treated for recto-urethral fistulae after RP between 1993 and 2008. All 17 patients were assessed for fistula recurrence in 2007 and received a standardised non-validated questionnaire to assess HRQL in 2011; furthermore, a patient's chart review was performed. Surgical technique: fistula closure was abdominal in 10 patients, perineal in five and combined abdominal and perineal in two, some with tissue interposition.RESULTS: In 2007, follow-up was available for 14 patients, one was deceased and two were lost to follow-up. The mean follow-up was 73.3 months and the mean patient age was 63 years. In two of the 17 patients, rectal injury during the initial surgery was reported; another three had undergone adjuvant radiation therapy (18%). In 2011, another two patients were deceased; the mean (range) follow-up was 99.5 (44-184) months. There was a great improvement in HRQL as compared with before surgery in seven of the 12 evaluable patients, a slight improvement in one and no change in three. In all, eight of the 12 patients were very satisfied with the surgery and four were satisfied.CONCLUSION: Perineal or abdominal fistula repair yields excellent success rates and high patient satisfaction. However, urinary incontinence can be found in some patients postoperatively, requiring further treatment.
AB - OBJECTIVES: To assess fistula recurrence rate and health-related quality of life (HRQL) after repair, as well as the impact on continence and erection in patients with recto-anastomotic fistula after radical prostatectomy (RP). In recent publications, the numbers of cases of recto-urinary fistulae after RP are relatively small. Success rates at fistula closure are good; however, data about functional outcomes and HRQL are more restricted.PATIENTS AND METHODS: A retrospective study of patients treated for recto-urethral fistulae after RP between 1993 and 2008. All 17 patients were assessed for fistula recurrence in 2007 and received a standardised non-validated questionnaire to assess HRQL in 2011; furthermore, a patient's chart review was performed. Surgical technique: fistula closure was abdominal in 10 patients, perineal in five and combined abdominal and perineal in two, some with tissue interposition.RESULTS: In 2007, follow-up was available for 14 patients, one was deceased and two were lost to follow-up. The mean follow-up was 73.3 months and the mean patient age was 63 years. In two of the 17 patients, rectal injury during the initial surgery was reported; another three had undergone adjuvant radiation therapy (18%). In 2011, another two patients were deceased; the mean (range) follow-up was 99.5 (44-184) months. There was a great improvement in HRQL as compared with before surgery in seven of the 12 evaluable patients, a slight improvement in one and no change in three. In all, eight of the 12 patients were very satisfied with the surgery and four were satisfied.CONCLUSION: Perineal or abdominal fistula repair yields excellent success rates and high patient satisfaction. However, urinary incontinence can be found in some patients postoperatively, requiring further treatment.
KW - Aged
KW - Anastomosis, Surgical
KW - Humans
KW - Male
KW - Middle Aged
KW - Prostatectomy
KW - Prostatic Neoplasms
KW - Quality of Life
KW - Rectal Fistula
KW - Recurrence
KW - Reoperation
KW - Retrospective Studies
KW - Treatment Outcome
KW - Urethral Diseases
KW - Urinary Fistula
KW - Urinary Incontinence
U2 - 10.1111/bju.12254
DO - 10.1111/bju.12254
M3 - SCORING: Journal article
C2 - 24053507
VL - 113
SP - 568
EP - 573
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 4
ER -