Major rectal complications following interstitial implantation of 125I for carcinoma of the prostate

From April 1975 through April 1983, 152 patients were treated for localized adenocarcinoma of the prostate with interstitial implantation of 125I seeds. In each case bilateral pelvic lymph node dissection was performed at implantation. Five rectal complications developed: 2 rectal ulcers and 3 prostatic urethrorectal fistulas. Our method to treat these problems is presented together with our technique of reconstruction in patients with persistent fistulas despite fecal diversion. While urethrorectal fistulas represent potentially devastating complications of the 125I implantation procedure, reconstructive techniques can minimize and have reduced their long-term effects