[Treatment of a vesicorectal fistula associated with a neurogenic bladder]

Area of Science:

• Urology
• Surgical Innovation
• Rectal Surgery

Background:

• Vesicorectal fistulas, particularly those associated with neurogenic bladder, present complex surgical challenges.
• Existing surgical approaches may involve significant morbidity, including anal sphincter damage.

Observation:

• A large vesicorectal fistula in a patient with neurogenic bladder was reported.
• An original surgical approach, adapting Kraske's procedure, was employed for fistula closure.

Findings:

• The adapted Kraske's approach allowed posterior rectal access, crucially avoiding damage to the anal sphincter structures.
• This technique offers a distinct advantage over the York-Masson approach, which necessitates anal sphincter division.

Implications:

• This modified Kraske's approach provides a valuable, sphincter-sparing alternative for exceptional cases of vesicorectal fistula.
• Knowledge of this technique is important for surgeons managing complex pelvic floor and urinary tract pathologies.