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