Endoscopic treatment of a rectovesical fistula following radical prostatectomy by over-the-scope clip (OTSC)

Brodak, Milos; Kosine, Josef; Tachecí, Ilja; Pacovsky, Jaroslav
July 2015
Videosurgery & Other Miniinvasive Techniques / Wideochirurgia i;2015, Vol. 10 Issue 3, p486
Academic Journal
The successful management of a rectovesical fistula after radical prostatectomy is difficult. Minimally invasive treatment by over-the-scope clip (OTSC) is a novel method. The authors present results with the use of OTSC. This method was used in 2 patients. The first patient had a rectovesical fistula detected on the fifth day after a prostatectomy. The second patient experienced rectal perforation during prostatectomy and a recurrent fistula after fistulorrhaphy. Both patients had a small fistula located in the vesicourethral anastomosis. Both patients underwent endoscopic OTSC placement. The median follow-up was 26 months. The success rate was 50%. The first patient healed successfully and the second patient had a relapse. The York-Mason procedure was eventually successful. According to our initial experience, the OTSC is suitable for small fistulas detected shortly after a prostatectomy. A more complex fistula, though small, carries a higher recurrence risk.


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