34 / 238
34
29
th
CONGRESS OF THE ESPU
CONCLUSIONS
In a review of the literature on treatment strategies in RDD concluded that clinical observation
without treatment is advisable when possible. Some patients show spontaneous regression while
others have a more chronic course with stable or progressive disease. Surgical debulking might be
necessary in the presence of symptoms or vital organ compression as in our case. Chemotherapy
is in general ineffective while radiotherapy has shown limited efficacy.
14:48–14:50
S2-15 (CP)
YORK & MASON PROCEDURE (TRANSRECTAL APPROACH)
FOR PERSISTENT RECTO-URETHRAL FISTULA,
AFTER SURGICAL TREATMENT OF AN INTERMEDIATE
ANORECTAL MALFORMATION. A CASE REPORT
Arthur LAURIOT DIT PREVOST
1
, Dyuti SHARMA
1
, Elsa ROBERT
2
,
Jean‑Christophe FANTONI
3
and Remi BESSON
1
1) Hopital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Chirurgie Pédiatrique, Viscérale et Urologique,
Lille, FRANCE - 2) Hopital Saint-Vincent de Paul, Groupement des Hopitaux de l'Institut Catholique de Lille, Chirurgie
Pédiatrique, Viscérale et Urologique, Lille, FRANCE - 3) Hopital Claude Huriez, Centre Hospitalier Universitaire de Lille,
Urologie, Lille, FRANCE
PURPOSE
Congenital recto-urethral fistula (RUF) is associated to anorectal malformations (ARM). Incidence
of RUF is around 30 to 80 cases per year (incidence of ARM: 1/2500 live births). Post operative RUF
represent -for adult urologist- one of the surgical complication of prostatectomy (2 %) and occurs
in 360 cases per year. We reported a case of persistent RUF after proctoplasty for ARM with occult
RUF.
CASE REPORT
A boy, born in January 2001, underwent proctoplasty for intermediate ARM without diagnosis of fis-
tula nor colostomy. At age of continence, the patient presented symptoms of RUF, with urinary leaks
through the anus. At 10-years old, the first surgical treatment of the fistula with perineal approach
was performed without success. Four years later, after several repeated orchitis, the patient was
addressed to our referral center of paediatric surgery for RUF treatment, after endoscopic examina-
tion. This case was discussed with both paediatric surgeon and adult urologist, and a York & Mason
trans-rectal approach was suggested. He was re-operated at age of 15, without colostomy.
RESULTS
Post-operative follow-up after one year was without recurrence, nor sphincter disorders.
CONCLUSIONS
York & Mason transrectal approach for RUF is feasible in older children, even without colostomy.
This surgical complex case represented a great opportunity for the paediatric urologist to work with
adult urologist and promote this collaboration for the transition of our young patients.
14:50–15:00
Discussion