Cure of urethro-rectal fistula secondary to a road traffic accident by perineal approach with gracilis flap interposition: A case report

• Published in: International journal of surgery case reports 2024-12, Vol.125, p.110564, Article 110564
• Main Authors: Foba, M.L., Fall, S.M.A., Ritz, F.J. Tchoungui, Sine, B., Beye, M., Sankalé, A.A.
• Format: Article
• Language: English
• Subjects: Case Report; Gracilis flap; Reconstruction; Trauma; Urethral fistula
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.110564

A urethro-rectal fistula is an abnormal communication between the urethra and the rectum. It is a rare entity. It is most often an iatrogenic lesion during prostate surgery. We present here the case of a post-traumatic urethro-rectal fistula secondary to a road accident. Surgical cure was via a perineal approach with gracilis flap interposition. This is a 15-year-old patient who consulted for a urethro-cutaneous fistula. Retrograde urethrography (RUG) with voiding cystourethrography (VCUG) showed a urethro-rectal fistula, with contrast leakage and opacification of the rectum. The fistula was cured using an anterior perineal approach with interposition of a gracilis flap. The post-operative course was uneventful. Urethro-rectal fistula is a rare entity and most often iatrogenic. Due to the rarity of this entity, the literature concerning its description, and its treatment is poor. Tailored approach should be considered for each patient. The use of gracilis flap interposition is describe as a good technique for managing urethro-rectal fistulas. Urethro-rectal fistula is a rare pathology, especially when it occurs following a road accident. Perineal cure with gracilis flap interposition appears to be a reliable technique. •Post-traumatic uretero-rectal fistula is a rare condition.•The literature on its management and description is sparse.•Ureterorectal fistulas are most often iatrogenic and secondary to prostate surgery.•The use of a gracilis muscle flap has enabled us to achieve a satisfactory result.