Low Residue Diet & Codeine May Substitute Faecal Diversion in Conservative Management of Patient with Rectourethral Fistula - A Case Report

Main Article Content

Sharfuddeen A. Mashi

Abstract

Aims: We present a patient that developed rectourethral fistula following prostatectomy for a misdiagnosed prostate cancer. He was managed conservatively without faecal diversion.

Case Presentation: A 65 year old man presented to our hospital with a year history of lower urinary tract symptoms. He was evaluated and diagnosed to have BPH. Serum PSA was wrongly reported to be 0.9 ng/ml. He had open prostatectomy. On the 6th post-operative day, he developed faecaluria. Rectal examination revealed a fistula, admitting tip of the index finger. Histology revealed adenocarcinoma. He had bilateral total orchidectomy a week later, but refused surgical repair of the fistula and urinary or faecal diversion. He was maintained on urethral catheterization, low-residue diet and codeine.

Discussion: The codeine and low residue diet made him constipated. Faecaluria stopped, fistula closed within 3 months. He however developed bladder neck contracture after a year.

Conclusions: In some selected cases, low residue diet and the use of codeine can replace faecal diversion in managing rectourethral fistula; this can save the patient from the agony of having colostomy, only for the fistula to recur later.

Keywords:
Rectourethral fistula, low residue diet, faecal diversion, codeine

Article Details

How to Cite
A. Mashi, S. (2017). Low Residue Diet & Codeine May Substitute Faecal Diversion in Conservative Management of Patient with Rectourethral Fistula - A Case Report. International Journal of Medical and Pharmaceutical Case Reports, 9(1), 1-4. https://doi.org/10.9734/IJMPCR/2017/32963
Section
Case Report