Algorithm-based multidisciplinary treatment approach for XXXX .

@entity1 @entity292 @entity263
PURPOSE: The purpose of this study is to report the outcomes of an algorithm-based multidisciplinary treatment approach to @entity292 . METHODS: This study is a retrospective review of a prospectively collected database at a tertiary center of all consecutive @entity1 treated between 2003 and 2013. RESULTS: Thirty males (mean age 63  years) were reviewed. @entity263 treatment was the most common @entity292 etiology (97  %). Urinary drainage consisted of urethral catheter in all @entity1 and suprapubic catheter in 14 (47  %). The rate of fecal diversion was 67  %. During a mean follow-up of 72  months, healing rate was 90  % and recurrence rate 0  %. Spontaneous healing was achieved in 14 @entity1 (47  %): 8 (27  %) without fecal diversion and 6 (20  %) following fecal diversion. Thirteen @entity1 (43  %) required definitive intervention. The majority of operated @entity1 underwent transanal or transperineal flap (endorectal, dartos, or gracilis) successfully. Only 2 @entity1 (7  %) required an abdominal approach (positive oncologic margins or non-functioning bladder). Fifteen out of the 20 @entity1 (75  %) who underwent fecal diversion had stoma closure with an overall permanent stoma rate of 17  %. Long-term urinary incontinence was noted in 11 @entity1 (37  %). Six @entity1 (20  %) required permanent urinary diversion or drainage catheters. CONCLUSIONS: Algorithm-based treatment approach for @entity292 is useful in the management of this rare condition. Selective fecal diversion is possible, and majority of @entity1 who require definitive intervention can be treated with a transanal or transperineal approach. The rate of permanent stoma is low, but long-term urinary dysfunction is frequent.
