Background: Rectourethral fistula is a rare complication of radical prostatectomy. Transanal endoscopic microsurgery(TEM) is a minimally invasive technique available for its surgical correction, although currently, TEM is used more commonly for excision of adenomas and stage T1 carcinomas of the rectum.
Patients and Methods: We report two patients with rectourethral fistulae after laparoscopic radical prostatectomy in whom TEM was used for closure. The surgical procedure included microscopic full-thickness excision of the rectal wall around the fistula with a 1-cm margin and endoscopic suturing of the defect in the urethral and rectal walls.
Results: In one case, the rectourethral fistula was closed using TEM. In the other patient, the procedure, performed after failure of a graciloplasty, was difficult because of extensive scar tissue, and the fistula persisted.
Conclusions: The TEM procedure is a minimally invasive technique that may be considered for surgical repair of rectourethral fistulae.
