Clase en vivo: “M.A.R. con fístula rectovesical”; claves para su corrección

Rectovesical fistula is a complex congenital anorectal malformation in males characterized by a fistula connecting the rectum to the bladder neck, requiring careful preoperative planning including colostomy placement, bladder mobilization, and preservation of vascularity during surgery. The condition presents with poor perineal anatomy (flat buttocks, absent intergluteal fold), associated urological anomalies (50% of cases), and carries a poor prognosis for fecal continence. Surgical correction involves meticulous dissection to preserve the distal segment, careful fistula division, and strategic colostomy management, with the surgeon needing to balance anatomical considerations against aesthetic positioning of the anus.