Recto-prostatic fistula is a rare complication of prostatic surgery, occurring usually because surgical planes are not appreciated. We describe a combined abdomino-perineal approach for the repair of a large recto-prostatic fistula with the interposition of omentum and gracilis without formally closing the fistula in layers.
A patient who was troubled by the persistent passage of prostatic calculi following transurethral prostatectomy is reported. The pathogenesis of these calculi is postulated.
The diagnosis of mullerian duct or utricular cyst should be considered in a child with urinary difficulties and a palpable midline, anterior rectal mass. Endoscopic cannulation of the cyst has been found to be the most useful diagnostic test. Infection should be treated with the appropriate antibiotics before definitive treatment. Surgical excision offers the best result. The transperitoneal and posterior parasacral approaches have been described but we favour the transvesical, transtrigonal approach which we find highly satisfactory. The risk of malignancy at a later age is an added indication for surgery.