A case of perforation of the prostatic abscess into the rectum resulting in a rectoprostatic fistula

Abstract

Introduction A rectoprostatic fistula complicating a prostatic abscess is extremely rare, and there are many uncertainties regarding its treatment and prognosis. Case presentation We present the case of a 68‐year‐old male who presented with rectal bleeding. Computed tomography reveals a prostatic abscess in contact with the rectum. As conservative treatment with antibiotics resulted in the aggravation of symptoms, we placed a transperineal catheter placement in the prostate, followed by drainage of the abscess through the catheter. The abscess communicated with the rectum, forming a rectoprostatic fistula. Subsequently, a transverse colostomy was performed. The abscess resolved, and no recurrence was observed even after 6 months of drainage. However, the rectal ulceration that resulted in the formation of the fistula persisted, and stoma closure was not achieved. Conclusion In cases of prostatic abscess complicated by rectoprostatic fistula, drainage of the abscess along with colostomy seems essential for a curative approach.

Keywords

• prostatic abscess
• rectoprostatic fistula
• transperineal catheter placement