An Unusual Case of Tubercular Recto-Prostatic Urethral Fistula

Rectourethral fistula is an uncommon occurrence. The usual anatomic site of occurrence is the prostatic urethra,in which a communication develops with the rectum. The common causes are surgery or radiotherapy for prostate cancer. Inflammatory causes are rare, and amongst them, tuberculosis is even rarer. There are only 9 cases of tubercular rectourethral fistula reported in literature. In this case report, we present a case of post-tubercular recto-prostatic urethral fistula, which was diagnosed by history, examination, MCU, cystourethroscopy and CT scan. The patient had a history of diagnosed pulmonary tuberculosis, for which he had received anti-tubercular therapy before. The patient was initially treated by urinary diversion along with ATT, and later on, fecal diversion by way of a colostomy was done, which resulted in resolution of symptoms. The patient did not require any definitive surgical repair of the fistula, as it healed on urinary and fecal diversion and medical management. On follow-up, recovery was good.