Minimally Invasive Management of Post-treatment Rectovesical Fistulae.

Objective: The aim of this study is to report our experience in minimally invasive management of rectovesical fistulae (RVFs). Materials and Methods: Between 2004 and 2021, 24 patients who underwent minimally invasive RVF repair by a single surgeon at 3 international institutions were retrospectively reviewed. Baseline demographic characteristics and perioperative and postoperative variables were collected. Complications were reported using the modified Clavien-Dindo Classification System and the European Association of Urology Complication Guidelines Panel Assessment and Recommendations. Fistula repair was defined as confirmation of fistula closure by imaging and complete resolution of fistula-related symptoms at the 12-month follow-up. Continuous variables are reported as medians and quartiles, whereas categorical variables are reported as frequencies and percentages. Results: Twenty-four patients with RVFs were treated: 22 males (91.7%) and 2 females with a median age of 66 (64.2-68) years. Twenty cases (83.3%) occurred postsurgery, three cases (12.5%) after surgery with combined radiotherapy, and one case (4.1%) after a combination of energy treatments. A robotic approach was performed in 19 patients (79%) and laparoscopic approach in 5 patients (21%). Ninety-six percent of patients had previous fecal diversions. No intraoperative complications were recorded. The median operative time was 180 (140-282) minutes, estimated blood loss was 50 (40-125) mL, and length of hospital stay was 2 (2-3) days. There were two Grade II complications and one Grade IIIb complication. All patients met criteria for repair. Conclusions: Minimally invasive management of RVFs is feasible. More studies are needed to assess the role of this approach among all RVF management options.

Gastrocystoplasty and Hematuria-dysuria Syndrome. What Role Plays Helicobacter Pylori? Case Report and Literature Review.

49 years male, who comes to the urology department, complaining of 8 months of lower abdominal pain, burning and oppressive type, of variable intensity reaching 9/10, which is occasionally exacerbated by urination, associated with intermittent gross hematuria, dysuria, refers no fever at any time. Patient with past medical history of bladder and right kidney Tuberculosis (TBC) 25 years ago, treated with a simple right nephrectomy and bladder augmentation with antrum segment of stomach, for low bladder capacity. Never showed any symptom during those 25 years lapsing time.