Interposition of the gracilis muscle to repair urethro-rectal fistula secondary to transvesical prostatic adenomectomy: case report

Introduction: We present the case of a 60-year-old male patient who developed a urethro-rectal fistula after transvesical prostate adenomectomy for benign prostatic hyperplasia. Symptoms included urine leakage through the rectum and recurrent urinary infections. Clinical case: Cystourethrography confirmed the presence of the fistula. The chosen treatment was gracilis muscle interposition, providing effective anatomical closure with well-vascularized tissue. In short-term follow-up, the patient achieved full recovery with no fistula recurrence and no functional impairment in the affected limb. Conclusion: This case highlights the efficacy of gracilis muscle interposition for managing complex urethro-rectal fistulas, contributing valuable insight for future therapeutic decisions in this challenging condition.