ESPU Congress 2018 - Abstract Book

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