Journal article
Radiation-induced complex anterior urinary fistulation for prostate cancer: a retrospective multicenter study from the Trauma and Urologic Reconstruction Network of Surgeons (TURNS)
World journal of urology, Vol.35(7), pp.1037-1043
07/2017
DOI: 10.1007/s00345-016-1983-3
PMID: 27928592
Abstract
To characterize anterior urinary fistulae following radiotherapy for prostate cancer.
Over 10 years, 31 men were identified to have an anterior urinary fistula. A retrospective database was created to evaluate patient demographics, presentation, diagnostic procedures, operative interventions, outcomes, and complications. Comparisons between men who underwent cystectomy versus bladder-sparing surgeries were performed.
At a median age of 73 (interquartile range (IQR) 68.5, 79) years, presenting symptoms included as follows: pubic pain (19/31, 61%), urine drainage via fistula (10/31, 32%), or a superficial wound infection (6/31, 19%). Recent instrumentation prior to diagnosis of anterior urinary fistula was reported by 18/31 (58%) at a median of 14.9 months (IQR 7.9, 103.8) after manipulation. Anterior fistula formation was either isolated to the pubic symphysis (19/31, 61%) or the thigh (12/31, 38%). Nineteen men underwent a cystectomy, whereas 12 men underwent a fistula repair. Excluding grades 1 and 2, 30- and 90-day postoperative complications were limited to four and two men, respectively, all of whom had a grade 3 complication. At 6-month follow-up, 26/31 (84%) men reported their pain had resolved. There was one fistula recurrence managed with subsequent cystectomy.
Complex anterior urinary fistulae to the pubic symphysis and thigh are devastating yet treatable conditions. Universally, these men have a history of radiotherapy and repeated endoscopic interventions. Surgical intervention with either cystectomy or primary repair was highly successful.
Details
- Title: Subtitle
- Radiation-induced complex anterior urinary fistulation for prostate cancer: a retrospective multicenter study from the Trauma and Urologic Reconstruction Network of Surgeons (TURNS)
- Creators
- E Charles Osterberg - Department of Surgery (Urology), Clinical Education Center, Dell Medical School, University of Texas, 1400 North I35, Suite 300, Austin, TX, 78701, USA. charlesosterberg@gmail.comAlex J Vanni - Department of Urology, Lahey Hospital and Medical Center, Burlington, MA, USAThomas W Gaither - Department of Surgery (Urology), Clinical Education Center, Dell Medical School, University of Texas, 1400 North I35, Suite 300, Austin, TX, 78701, USAMohannad A Awad - Department of Surgery (Urology), Clinical Education Center, Dell Medical School, University of Texas, 1400 North I35, Suite 300, Austin, TX, 78701, USAJoshua A Broghammer - Department of Urology, University of Kansas, Kansas City, KS, USAScott C Pate - Department of Urology, University of Kansas, Kansas City, KS, USAHadley Wyre - Department of Urology, University of Kansas, Kansas City, KS, USAJeremy B Myers - Department of Surgery (Urology), University of Utah, Salt Lake City, UT, USASean P Elliott - Department of Urology, University of Minnesota, Minneapolis, MN, USASuprita Krishna - Department of Urology, University of Minnesota, Minneapolis, MN, USALee C Zhao - Department of Urology, New York University, New York, NY, USAChristopher McClung - Central Ohio Urology Group, Columbus, OH, USABradley A Erickson - Department of Urology, University of Iowa, Iowa City, IA, USABenjamin N Breyer - Department of Surgery (Urology), Clinical Education Center, Dell Medical School, University of Texas, 1400 North I35, Suite 300, Austin, TX, 78701, USA
- Resource Type
- Journal article
- Publication Details
- World journal of urology, Vol.35(7), pp.1037-1043
- Publisher
- Germany
- DOI
- 10.1007/s00345-016-1983-3
- PMID
- 27928592
- ISSN
- 0724-4983
- eISSN
- 1433-8726
- Grant note
- name: Alafi Foundation
- Language
- English
- Date published
- 07/2017
- Academic Unit
- Urology
- Record Identifier
- 9984051574802771
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