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Article
April 30, 1932

THE SPONTANEOUS CLOSURE OF FRESH URETHRORECTAL FISTULA: REPORT OF THREE CASES, WITH PRESENTATION OF A MANOMETER SUPRAPUBIC URINARY DRAINAGE APPARATUS

Author Affiliations

OMAHA

From the University of Nebraska College of Medicine.

JAMA. 1932;98(18):1542-1545. doi:10.1001/jama.1932.02730440022006
Abstract

My purpose is to submit substantial evidence contrary to the commonly accepted view that simultaneous perforation of the walls of the rectum and the prostatic urethra, in the presence of a dilated and functionless internal vesical sphincter, results inevitably in chronic urethrorectal fistula. The spontaneous closure of existing, fresh urethrorectal fistula, in the three cases here presented, has followed combined suprapubic and urethral urinary aspiration, by means of an efficient and simple apparatus here described. These three patients also received free catharsis, as well as frequent irrigations of the bladder and the perineal fistulous tract. Two of these three urethrorectal fistulas followed perineal prostatectomy. The third followed an attempted repair of a chronic urethrorectal fistula. In all three, at the time the treatment was instituted, there was gross fecal drainage through the suprapubic fistula, as well as both fecal and urinary drainage through the perineum. In each case the internal

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