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

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. (C) 2013 Elsevier Inc. Open access under CC BY-NC-ND license.