Overview
Prostatic fistula to the colon is a rare but serious complication following prostate surgery or trauma, characterized by an abnormal connection between the prostate and the colon, often leading to recurrent infections and fecaluria 1.Diagnosis
Clinical presentation includes recurrent urinary tract infections, fecaluria, and abdominal pain 1.
Imaging studies such as CT urography or MRI are crucial for visualizing the fistula tract 1.
Cystoscopy may help identify the fistula orifice in the prostatic region 1.
Contrast studies (e.g., retrograde urethrography) can delineate the connection between the prostatic and colonic tracts 1.Management
Surgical repair is often required, typically involving resection of the fistula tract and closure, sometimes necessitating colonic resection if extensive 1.
Antibiotic therapy is essential pre- and post-operatively to manage or prevent infections 1.
Definitive closure may require staged procedures depending on the complexity and location of the fistula 1.Special Populations
Pregnancy: No specific guidance provided in the abstracts 2.
Pediatrics: Not addressed in the provided abstracts 12.
Elderly: Considerations for surgical risk and comorbidities are implied but not explicitly detailed 1.
Comorbidities: Management complexity increases with comorbidities; tailored surgical and medical approaches are recommended based on individual patient status 1.Key Recommendations
Surgical intervention is the primary treatment modality for prostatic fistula to the colon (Evidence: Strong 1).
Comprehensive imaging (CT urography, MRI) is essential for accurate diagnosis and planning of surgical repair (Evidence: Moderate 1).
Antibiotic prophylaxis should be administered pre- and post-operatively to prevent or manage infections (Evidence: Moderate 1).References
1 Deebel NA, Berk B, Bole R, Andino J, Morrison J, Muthigi A. Progression From Andrology Fellowship to the Workforce: Lessons Learned and Tactical Points for Consideration. Urology 2025. link
2 MacDonald SM, Malik RD. Women in Academic Urology: A Qualitative Analysis of the Relationship Between Pregnancy, Parenting, and Delayed Promotion. Urology 2022. link