Abstract：
OBJECTIVE:To validate the Martini staging system for postoperative rectourethral fistula (RUF) utilizing data from previous studies to determine whether it can accurately predict postoperative success rate. METHODS:A systematic search of peer-reviewed studies was conducted through January, 2020. The primary inclusion criteria for the studies were studies that evaluated outcomes based on the etiology of the fistula (ie, radiotherapy/ablation [RA] vs nonradiotherapy/ablation [NRA]). Martini RUF classification was utilized for the subgroup analysis. RESULTS:Out of 1948 papers, 7 studies with a total of 490 patients (251 in RA vs 239 NRA) were included in this study. Receiving RA increased the risk of permanent bowel diversion by 11.1 folds, eventual fistula recurrence by 9.1 folds, and post-op urinary incontinence (UI) by 2.6 folds. Similarly, compared to a Grade 0 fistula, a Grade I fistula increased the risk of permanent bowel diversion by 9.1 folds, fistula recurrence by 20 folds, and post-op UI by 2.7 folds. There were some valuable variables that were not captured by the Martini classification. CONCLUSION:Overall, the Martini classification system is efficacious in stratifying post-op complications from RUF repair based on the grade and etiology; however, it is limited in application. There is an opportunity for the development of more comprehensive staging systems in this domain.
journal_name
Urologyjournal_title
Urologyauthors
Mishra K,Mahran A,Abboud B,Bukavina L,Elshafei A,Ray A 3rd,Fernstrum A,Abboud R,Elgammal M,Zhao LC,Gupta Sdoi
10.1016/j.urology.2020.08.047subject
Has Abstractpub_date
2021-01-01 00:00:00pages
299-305eissn
0090-4295issn
1527-9995pii
S0090-4295(20)31098-0journal_volume
147pub_type
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