What Researchers Did
Researchers retrospectively reviewed the charts of 6 patients who developed rectourethral fistulas after combination radiotherapy for localized prostate cancer and subsequent rectal procedures.
What They Found
All 6 patients in the study developed a rectourethral fistula after combination radiotherapy and subsequent rectal biopsy or hemorrhoidectomy, with an average time of 22.6 months between radiotherapy completion and fistula development. Treatment attempts included hyperbaric oxygen therapy, which failed in all 4 patients who received it, and major surgeries such as fecal diversion with gracilis interposition flaps (3 patients) or pelvic exenteration (2 patients).
What This Means for Canadian Patients
Canadian patients undergoing combination radiotherapy for prostate cancer should be aware of the potential for rectourethral fistula development, especially if subsequent rectal procedures are performed. To minimize this serious complication, patients should discuss with their doctors the risks of elective rectal surgery or biopsies of rectal ulcers after such radiotherapy.
Canadian Relevance
This study has no direct Canadian connection.
Study Limitations
The main limitation of this study is its small sample size of only 6 patients, which limits the generalizability of the findings.