Rectal injury in radical perineal prostatectomy.

OBJECTIVE To report our experience in treating patients with rectal injury with radical perineal prostatectomy. METHODS Medical charts of 176 patients submitted to radical perineal prostatectomy from 1996 to 2005 were reviewed to identify rectal problems. A review of rectal injury in prostatectomy is provided. RESULTS Of 176 patients who underwent radical perineal prostatectomy, 10 (5.7%) had rectal injury and 4 (2.3%) presented rectal fistula. Two (1.1%) patients were submitted to colostomy. We discuss how to avoid and treat the complications. CONCLUSIONS There is a real risk of rectal injury during radical perineal prostatectomy, particularly during the learning period or if the approach is not often performed. Fistula might occur, but colostomy is actually unnecessary and rare. A better understanding of the perineal anatomy and knowledge about the technique is recommended before practicing radical perineal prostatectomy.