Rectourinary Perineal Fistula

Rectourinary perineal fistula is a super-rare intermediate anomaly that has been reported only by us [12,16]. We have seen two boys who presented in infancy in the 1970s. The first had a large opening in the anterior perineum through which he passed both urine and feces without control and through which mucosa prolapsed. He had a small hypospadiac penis with severe chordee and multiple associated malformations. When the prolapse was reduced, the interior of the bladder and the rectum could be seen. Bowel formed the posterior quadrant and bladder formed the anterior three quadrants (Figs. 15.4 and 15.5). The second had a smaller opening at the same site through which he passed both urine and feces and through which mucosa prolapsed. He also had hypospadias with severe chordee and penoscrotal transposition, but he was continent and had no other anomalies. After the prolapse was reduced, we found that the urethra formed the anterior quadrant and bowel formed the three posterior quadrants (Figs. 15.6 and 15.7). We named the first anomaly "rectovesicoperineal fistula" and named the second anomaly "rectourethroperineal fistula". These are now included in the Krickenbeck classification as forms of H-fistula.

Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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