Acquired Rectourethral Fistulas in Adults: A Systematic Review of Surgical Repair Techniques and Outcomes

BACKGROUND:Rectourethral fistulas are uncommon. Retrospective studies and case reports have highlighted various approaches for surgical repair. Because clinical presentations and technical expertise vary widely, no single procedure has been universally adopted. OBJECTIVE:We sought to qualitatively analyze studies describing surgical techniques and outcomes in adult acquired rectourethral fistulas to outline universal approaches for evaluation and management. DATA SOURCES:MEDLINE (PubMed, Ovid) and the Cochrane Library were searched by using the terms rectourethral fistulas, recto-urethral fistulas, urethrorectal fistulas, and prostatourethral-rectal fistulas. STUDY SELECTION:All studies were retrospective, in English, and reported at least 4 cases. Any series with >50% congenital cases or