Proctalgia fugax – a nightmare drowned in enema

@article{Olsen2008ProctalgiaF,
  title={Proctalgia fugax – a nightmare drowned in enema},
  author={Benedikte Sommerbakk Olsen},
  journal={Colorectal Disease},
  year={2008},
  volume={10}
}
  • B. Olsen
  • Published 1 June 2008
  • Medicine
  • Colorectal Disease
Dear Sir, It is with great interest we read the article by Shakespeare et al. [1] Three patients are described who developed a recto-urethral fistula not only within 15– 24 months after brachytherapy, but also 3–4 months after transrectal biopsy! Performing invasive procedures in radiated and severely contaminated tissue may cause severe infectious complications as well as nonor slowhealing ulcerating wounds [2–4]. We examined a patient after treatment with radioactive seeds for prostate cancer… 

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References

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Recto‐urethral Fistula following brachytherapy for localized prostate cancer

  • J. JongenP. BraunK. Jünemann
  • Medicine
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • 2008
TLDR
In severe proctitis with ulceration in the distal anterior rectum, noninvasive diagnostic procedures should be performed first (to exclude rectal or recurrent malignancy); in the cases described in the article the three patients developed ‘significant ano-rectal pain and urinary discharge per rectum’ after the biopsy.

Proctalgia fugax: would you recognize it?

TLDR
Treatment may be difficult, but if the attacks of pain are numerous and severe, a calcium channel blocker such as nifedipine (Adalat, Procardia) should be tried.

Late progress of radiation-induced proctitis.

TLDR
Patients with late radiation-induced proctitis who presented after a median latency of 13 months were studied retrospectively, and it can not be characterised as a harmless manifestation of late radiation injuries.

Rectal Complications After Prostate Brachytherapy

TLDR
Although diversion of fecal stream does not heal the fistula, all patients diagnosed with rectal-urethral fistula should first undergo diverting ostomy to alleviate symptoms, and one should consider definitive resection and ostomy closure.

Prostatourethral‐rectal fistula after prostate brachytherapy

TLDR
Brachytherapy has seen increased utilization as a potentially curative treatment for patients with localized initial or recurrent prostate carcinoma, but prostatourethral‐rectal fistula (PRF) is a serious complication, and its incidence, clinical presentation, and risk factors for occurrence have not been documented thoroughly.

Frequency of Functional Bowel Disorders among Healthy Volunteers in Mexico City

TLDR
The prevalence of IBS was significant and is related to a number of factors, including the stress of living in an overpopulated city, and selection bias is likely operative.

Anorectal injury following pelvic radiotherapy

TLDR
This review presents the existing evidence and identifies areas that require further work on the effects of radiation on the anorectum.