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Can Urol Assoc J. 2014 Jan-Feb;8(1-2):E57-9. doi: 10.5489/cuaj.1112.

Penile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy.

Author information

1
Division of Urology, Vancouver Island Health Authority, Victoria, BC;
2
Department of Radiation Oncology, BC Cancer Agency - Vancouver Island Centre, Victoria, BC;
3
Division of Laboratory Medicine and Pathology, Vancouver Island Health Authority, Victoria, BC;
4
Division of Plastic Surgery, Vancouver Island Health Authority, Victoria, BC;
5
Division of General Surgery, Vancouver Island Health Authority, Victoria, BC;
6
Division of General Surgery, Vancouver Island Health Authority, Victoria, BC; ; Division of Critical Care, Vancouver Island Health Authority, Victoria, BC.

Abstract

Radiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years post-external beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myo-cutaneuos flap closure of the perineum.

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