Editing Functional: Urinary Fistulae (section)

==== Diagnosis and Evaluation ====
* '''History and Physical exam'''
**Symptoms may include fecaluria, hematuria, UTI, nausea, vomiting, and fever
* '''Imaging'''
**'''Lower tract imaging'''
***'''VCUG or retrograde urethrogram usually provides a definitive diagnosis of rectourethral fistula'''
**'''Upper tract imaging should be performed in patients to exclude a related ureteral injury'''
*'''Other'''
**'''In patients with a history of pelvic malignancy, biopsy of the fistula is suggested to evaluate for a local recurrence of the tumour''' 
***Cystoscopy and sigmoidoscopy visualize the fistula tract in the vast majority of cases and provide a mechanism for biopsy
** '''Assessment of continence and sphincteric function in patients with rectourethral fistula after radical prostatectomy'''
***Given the location of most rectourethral fistulas at or near the vesicourethral anastomosis and the membranous urethra, there is a risk for persistent severe stress incontinence postoperatively after rectourethral fistula repair