# Successful Urethrorectal Fistula Repair Using GelPOINT Path Anal Access Sheath in Pelvic Fracture Urethral Injury

## TL;DR

A new surgical method using a transanal device successfully repaired a rare fistula between the urethra and rectum in a young male patient.

## Contribution

The use of the GelPOINT Path access sheath for transanal repair of urethrorectal fistulas is presented as a novel surgical approach.

## Key findings

- The GelPOINT Path access sheath provided wide access for successful fistula closure.
- Postoperative results showed excellent urethral function with no recurrence of the fistula.
- The method involved a combined transperineal and transanal approach reinforced with a muscle flap.

## Abstract

We present a case of rectourethral fistula complicating urethral trauma, successfully treated using a transanal exposure device.

A male in his twenties was referred to us with a pelvic fracture urethral injury. Preoperative imaging revealed an urethrorectal fistula. Excision and primary anastomosis urethroplasty was performed transperineally. The fistula was primarily closed transanally via GelPOINT Path access sheath, which provided wide access to the anal canal. The closure was reinforced perineally, with a gracilis muscle flap interposition. Postoperative urethral patency was excellent without recurrent fistula.

This method could be an effective alternative for urethrorectal fistula repair.