A case of an iatrogenic vesicourethral fistula following an anastomotic urethroplasty with progressive perineal approach for a posterior urethral distraction defect

A 54 year old male sustained a pelvic fracture injury due to a railway accident. An anastomotic urethroplasty with progressive perineal approach was carried out elsewhere after eight months. He presented to our centre with a per-urethral catheter in place and peri-catheter leak of urine. A diagnosis of an iatrogenic vesicourethral fistula was made. A false passage connecting the bladder to the bulbar urethra following an anastomotic urethroplasty with progressive perineal approach can occur if adequate care is not taken intra-operatively. Identifying the proximal urethra prior to anastomosis by flexible cystoscopy can avoid this complication.