Male urethral fistula

Even if we don't have medical expertise, we all know that everyone's urine is discharged from the urethra. Even though the body structures of men and women are different, this is the same. If someone has a special situation, such as a fistula in the urethra of some men, this will cause them to urinate directly from the fistula instead of through the urethra. What is the matter with male urethral fistula?

Rectourethral fistula is a fistula connecting the rectum and urethra, and stool can be discharged through the urethra. The causes are divided into congenital and secondary. It is mostly congenital in children, mostly boys, and is more common in congenital high or middle anorectal malformations, caused by obstruction of the ureterorectal septum separating the cloaca at 4 to 7 weeks of embryo. According to the location of the fistula, it can be divided into prostatic rectourethral fistula and bulbar rectourethral fistula. The child is born without an anus, and there is feces or "bubble urine" in the urine. Cystourethrography can confirm it. Most children undergo transverse colostomy due to anorectal malformations in the neonatal period. When the abdominosacral perineal rectoplasty is performed, the fistula is ligated at the same time and a double-lumen urinary catheter is placed to drain urine. Secondary fistulas are usually caused by trauma or tumors. The fistula is usually located in the membranous urethra. Treatment should be based on the cause. Urethral fistula repair surgery can be performed transperineally or transrectally.

1. Urine incontinence: Urine flows out of the vagina from time to time.

2. Infection of the skin of the vulva, buttocks, and inner thighs: Due to long-term immersion in urine, dermatitis, rash, and eczema of varying degrees occur, causing local itching and burning pain. If scratched, it can cause secondary infection and form swelling. Patients with urethral fistulas may sometimes have varying degrees of urinary tract infection symptoms. If it is a ureteral fistula accompanied by local ureteral stenosis, resulting in renal pelvic dilatation and hydrops, it is more likely to cause infection. Some people first develop retroperitoneal urine extravasation, complicated by infection, and then vaginal urine leakage occurs, which is occasionally seen after radical surgery for cervical cancer.

4. Mental pain: Since urine is continuously discharged from the vagina regardless of day or night and season, it wets clothes, pants and bedding, making it impossible to sleep well at night. It is inconvenient or unwilling to go out to participate in social activities during the day, affecting study and production labor. In addition, some patients with inconvenience may have vaginal scarring, stenosis or partial closure, loss of sexual life and fertility, affecting the relationship between husband and wife and family relationships. All these bring great mental pain to patients, leading to depression and secondary amenorrhea.