Prenatal Diagnosis and Management of Isolated Recto-Urethral Prostatic Fistula: A Case Report

Background: Recto-urethral prostatic fistula (RUPF) is a rare form of anorectal malformation (ARM). Its prenatal diagnosis and management with a minimum consequence are challenging. This study aimed to present diagnostic and therapeutic modalities in a patient with RUPF. Case report: A 32-year-old pregnant woman with no relevant medical or surgical history at 27 weeks of gestation was referred to our department of pediatric surgery. Prenatal ultrasound showed loop dilatations and enterolithiasis. Fetal magnetic resonance imaging (MRI) imaging confirmed the diagnosis of ARM and suggested the presence of a recto-urinary fistula. There was no other associated malformation. Parents decided on the continuation of pregnancy after counseling. A 2300 g male was born at 37 weeks of gestation in February 2019. Colostomy followed by laparoscopic pull-through were performed. Expectations of the physician and parents were met after a one-year follow-up period. Conclusion: Fetal MRI had the potential to diagnose ARM more accurately than ultrasound. Moreover, laparoscopic pull-through was safe and feasible.