Transanal repair of a recto-urethral fistula after robotic prostatectomy

Recto-urethral fistula (RUF) is an uncommon but debilitating post-operative complication after prostatectomy. Surgical repair is the definitive treatment though recurrence rates can be high. The approach varies depending on individual circumstances and includes transanal, transperineal, transsphincteric, or transabdominal repair. Surgical adjuncts, such as the use of a tissue interposition flap or mesh and pre-operative fecal or urinary diversion, are other considerations. Here we describe transanal repair of a RUF after robotic prostatectomy with a rectal advancement in a patient who underwent fecal and urinary diversion.