Low Residue Diet & Codeine May Substitute Faecal Diversion in Conservative Management of Patient with Rectourethral Fistula - A Case Report
Journal Title: International Journal of Medical and Pharmaceutical Case Reports - Year 2017, Vol 9, Issue 1
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.
Authors and Affiliations
Sharfuddeen A. Mashi
Keywords
Related Articles
- EP ID EP309392
- DOI 10.9734/IJMPCR/2017/32963
- Views 94
- Downloads 0
Isoniazid-Induced Psychosis in 2 Children Treated for Tuberculosis: Case Reports and Literature Review
Aims: To report isoniazid-induced psychosis in 2 children treated for Tuberculosis (TB) as a reminder or an alert to clinicians and other health workers. Presentation of Cases: Isonicotinic acid hydrazide (INH) is common...
Vasospasm after Collagenase Clostridium Histolyticum Infiltration in Dupuytren’s Contracture
Treatment with collagenase clostridium histolyticum has been shown to be effective at the short- and mid-term against Dupuytren’s contracture in which cords have formed. As with any new drug, pharmacovigilance studies wi...
Lung Adenocarcinoma with Coexistent Primary Hyperparathyroidism
The simultaneous presence of lung carcinoma and primary hyperparathyroidism, both causative conditions for hypercalcemia, is quite rare. A 56-year-old woman was diagnosed with hypercalcemia, caused by asymptomatic primar...
Giant Hydronephrosis Containing Eighteen Liters of Fluid in a Child: A Case Report
Giant hydronephrosis is defined as the accumulation of more than 1L of fluid in the collecting system of the kidney. We present a case of giant hydronephrosis containing 18 L of fluid in a 13- year- old girl resulting fr...
Meningococcal Septic Shock with Polyarticular Arthritis and Hemorrhagic Skin Lesions in a 70-Year-Old Immunocompetent Woman
Aim: To describe a case of meningococcal polyarthritis and hemorrhagic skin lesions in an immunocompetent woman with meningococcal septic shock. Case Presentation: Α 70-year-old woman was presented to the emergency room...