Rectourethral fistula (RUF) is a rare entity that can develop after prostate surgery , trauma, radiation, congenital diseases or inflammatory bowel disease. Successful management often requires an aggressive approach. Several techniques have been described to repair them. Herein we present our experience with laparoscopic RUF repair. Six patients were treated. RUF developed after open simple prostatectomy in 1 case, open radical prostatectomy in 4 cases, and transurethral prostate resection (TURP) in the last case. The operat localization of the tract (bladder-prostate). When the the fistulous tract involved the prostate capsule, the technique included a capsulectomy and urethro-vesical anastomosis. When the bladder was involved a transvesical approach was used.

The mean operative time was 212 minutes (range 180-240). The mean hospital stay was 2.6 days (range 2-3). No complications occurred. All patients remain free of fistula recurrence and the last case was 7 months ago.

Laparoscopic repair of RUF is feasible and represents an attractive alternative to the standard approaches. The laparoscopic technique facilitates concomitant colostomy and tissue interposition without the need for patient repositioning or an additional incision.