Steven Dixon1, Iain JD McCallum1, Chris Dennison2 and Mark Katory3*
1Department of Colorectal Surgery, Queen Elizabeth Hospital, UK
2Department of Radiology, Queen Elizabeth Hospital, UK
3Department of Surgery, Queen Elizabeth Hospital, UK
Introduction: Low anterior resection is the commonest operation in the United States of America undertaken for low rectal cancers. Seminal vesicle-rectal fistula is an extremely uncommon complication of this operation. The objective of this literature review is to investigate risk factors that lead to the development of seminal vesicle-rectal fistula; clinical presentation; and investigation and management options.Methods: There were 9 articles of relevance which reported a total of 12 cases of seminal vesiclerectal fistula. All other iatrogenic or cryptogenic fistula was excluded.Results: 12 cases were identified in the literature, and we describe 1 further case. Pneumaturia and fever were presenting symptoms in 10 of 13 cases. 69.2% (n=9) of cases presented within 2 weeks of the procedure. CT was the investigation of choice in 9 of 13 cases. A variety of surgical and conservative management plans were utilized. Conservative management was successful in 46.1% (n=6) of cases.Discussion: This study provides the first concise review of seminal vesicle-rectal fistula following low anterior resection and also adds a further case. It is also the first article of its kind to recommend a treatment algorithm which consists of a trial of conservative management.
Dixon S, McCallum IJD, Dennison C, Katory M. Seminal Vesicle-Rectal Fistula: A Review of an Unusual Complication Following Low Anterior Resection for Rectal Cancer. Clin Surg. 2016; 1: 1136.