Seminal vesicle fistula following abdominoperineal resection for recurrent adenocarcinoma of the rectum. Report of a case.

Abstract

Fistula formation between the seminal vesicles and a pelvic abscess after abdominal perineal resection for recurrent rectal cancer is reported in a 32-year-old male previously treated with low anterior resection, chemotherapy, and radiation. The case history was reviewed for clinical presentation, radiologic studies, and laboratory data. Successful management of this previously unreported complication included percutaneous abscess drainage, antimicrobial therapy, and oral administration of Proscar (Merck, Sharpe & Dohme, Rathway, NJ). Multiple factors predisposed this patient's development of a seminal vesicle fistula. These include extensive scarring from previous surgery, pelvic radiation, and an immunologically depressed status. The efficacy of Proscar in the successful management of this case remains unknown.