• Mehmet Yıldırım, Cemal Göktaş, Rahim Horuz, Cihangir A Cetinel, Onder Cangüven, Hasan Fehmi Küçük, and Selami Albayrak.
• Department of General Surgery, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey.
• Ulus Travma Acil Cer. 2012 May 1;18(3):250-4.

BackgroundWe evaluated the data of our patients who experienced rectal injury during radical prostatectomy (RP).MethodsWe analyzed the data for the 7 patients (6 perineal, 1 retropubic) with iatrogenic rectal injury who were selected from 451 patients with RP (218 retropubic, 233 perineal) operated in our clinic between 2003 and 2011.ResultsThe mean age of the 7 patients was 64.4 years. Rectal injury occurred during prostatic apical dissection in 4 patients, during dissection of Denonvilliers fascia in 1 patient, during transection of the rectourethral muscles in 1 patient, and during dissection of the rectal region proximal to the anal sphincter in 1 patient. The mean size of the lesions was 2 (1-4) cm. All of the rectal injuries were recognized during the operation, and double-layered sutures were used for the primary repair. None of the cases required colostomy procedure. No postoperative complications were encountered in 6 of the patients; however, 1 patient underwent a second operation on the following day due to detachment at the injury site. None of the patients displayed urethrorectal fistula, urinary incontinence or urethral stricture.ConclusionPrimary repair with double-layered suturing is sufficient for the treatment of rectal injuries that occur during RP if they are recognized intraoperatively.

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