Post-Swenson's rectourethral fistula repair using the posterior sagittal route

摘要

Formation of rectourethral fistulas following pullthrough procedures for Hirschsprung's disease is a rare but recognized complication. Surgical correction is challenging, with use of vascularized grafts associated with high recurrence rates. We report on such a complication in a young boy whose repair was first approached anteriorly, utilizing vascularized omentum as a urethral patch. With recurrence of the fistula the urethral breech was ultimately repaired by direct tissue approximation via the posterior sagittal route.