A Rectourethral Fistula due to Transrectal High-Intensity Focused Ultrasound Treatment : Diagnosis and Management

Abstract EN

Colovesical fistula (CVF) is an abnormal connection between the enteric and the urinary systems.

The rectourethral fistula (RUF) is a possible but extremely rare complication of treatment of prostate cancer with “transrectal High-Intensity Focused Ultrasound (HIFU) treatment.” We present a case of CVF due to HIFU treatment of recurrent prostate cancer.

The case was assessed with cystography completed with a pelvic CT scan—with MPR, MIP, and VR reconstruction—before emptying the bladder.

Since the CT scan confirmed that the fistula involved solely the urethra and excluded even a minimal involvement of the bladder, it was possible to employ a conservative treatment by positioning a Foley catheter of monthly duration, in order to allow the urethra to rest.

Still today, after 6 months, the patient is in a good clinical condition and has not shown yet signs of a recurrence of the fistula.