A rather rare and bizarre medical condition called a Rectourethral fistula or Rectal prostate fistulas has come to the fore after a group of doctors last month published a case study on it in the Cureus Journal of Medical Science.
Rectal-prostate fistulas are uncommon anatomical connections between the prostatic urethra and the rectum. In this unusual medical condition, a patient urinates and ejaculates sperm from the rectum rather than its usual exit, the urethra.
The case study published in the medical journal was carried out on a 33-year-old male, who had approached the doctors after he experienced five days of testicular pain. The doctor noted that for the last two years, the patient had been passing gas in his urine (pneumaturia), urinating faeces, also known as ‘fecaluria’ in medical terms and passing a “substantial amount” of urine and semen from his anus. The patient, however, only sought medical help when he started experiencing pain in his testicles.
A CT scan of the man’s pelvis later revealed he was experiencing a chronic case of “rectourethral fistula”.
Experts said that other illnesses such as prostate cancer, rectal cancer, surgery, or severe trauma are the most common causes of the occurrence of this rare ailment. A substantial number of cases have happened “during times of war”. The symptoms of this disease are pneumaturia, fecaluria, hematuria, and urinary tract infections.
However, in this case, the reason was not immediately clear as the man denied having undergone “abdominal surgeries, rectal manipulation and penetration, or rectal trauma,” according to the study.
Later it was revealed that the uncommon pathologic condition occurred in the patient due to traumatic Foley catheter insertion.
The study reveals that the 33-year-old man, who had a history of illicit drug use, had spent three weeks in a state of coma, due to the regular consumption of a combination of cocaine and phencyclidine (better known as PCP, or “angel dust”) for two years. During those three weeks of his stay in the hospital, he was administered a Foley catheter, a thin, sterile tube inserted into the bladder to drain urine in hospitalized patients. Experts believe that the injury was likely caused by the catheter, as it made a hole creating a pathway between the urethra and rectum.
But the good news is that the team of doctors treating the 33-year-old man were able to plug the opening. They also used a catheter put above the pubic region to allow the man to relieve himself for a short period of time. Finally, the patient made a near-perfect recovery.
While being able to, fortunately, cure the rather bizarre medical condition the patient went through, the team concluded that while Foley catheters are of importance in the treatment of patients, doctors need to be aware of potential (and rare) complications that can result from their use.