优美肌肉介入（GMI）已与治疗复杂门诊瘘的有利结果相关。 GMI的结果可能会根据瘘的病因而变化，特别是女性直肠阴道瘘和男性直肠尿道瘘（RUF）之间的区别。本研究旨在评估GMI治疗前列腺癌治疗后获得的RUF的结果。本回顾性队列研究包括在弗罗里达克利夫兰诊所结肠外科部门进行GMI治疗的男性患者，治疗时间为2000年1月至2018年12月。主要结局是GMI成功，定义为RUF完全愈合而无复发。次要结果是住院时间和术后并发症。该研究包括53名中位年龄为68（范围，46-85）岁的男性患者。患者在放射治疗（52.8％），手术（34％）或经尿道前列腺切除术（TURP）（13.2％）后发展了RUF。中位住院时间为5（IQR，4-7）天。二十（37.7％）名患者经历了25个并发症，最常见的是创口感染和裂开。 GMI后达到初步愈合的有28（52.8％）名患者。另外15名患者在额外的治疗后成功愈合RUF，总成功率为81.1％。完全愈合的中位时间为8（范围，4-56）周。研究结果表明，创口裂开是与GMI结果有关的唯一重要因素（p = 0.008）。虽然GMI的初始成功率约为53％，但在额外的治疗后增加到81％。GMI后的并发症大多较小，其中创口并发症最常见。门诊瘘创口裂开与GMI后RUF愈合失败有显著关系。©2023.Springer Nature Switzerland AG.

Gracilis muscle interposition (GMI) has been associated with favorable outcomes in treating complex perianal fistulas. Outcomes of GMI may vary according to the fistula etiology, particularly between rectovaginal fistulas in women and rectourethral fistulas (RUF) in men. The aim of this study was to assess the outcome of GMI to treat RUF acquired after prostate cancer treatment.This retrospective cohort study included male patients treated with GMI for RUF acquired after prostate cancer treatment between January 2000 and December 2018 in the Department of Colorectal Surgery, Cleveland Clinic Florida. The primary outcome was the success of GMI, defined as complete healing of RUF without recurrence. Secondary outcomes were length of hospital stay and postoperative complications.This study included 53 male patients with a median age of 68 (range, 46-85) years. Patients developed RUF after treatment of prostate cancer with radiation (52.8%), surgery (34%), or transurethral resection of the prostate (TURP) (13.2%). Median hospital stay was 5 (IQR, 4-7) days. Twenty (37.7%) patients experienced 25 complications, the most common being wound infection and dehiscence. Primary healing after GMI was achieved in 28 (52.8%) patients. Fifteen additional patients experienced successful healing of RUF after additional procedures, for a total success rate of 81.1%. Median time to complete healing was 8 (range, 4-56) weeks. The only significant factor associated with outcome of GMI was wound dehiscence (p = 0.008).Although the initial success rate of GMI was approximately 53%, it increased to 81% after additional procedures. Complications after GMI were mostly minor, with wound complications being the most common. Perianal wound dehiscence was significantly associated with failure of healing of RUF after GMI.© 2023. Springer Nature Switzerland AG.