A 65-year-old man developed an anterior rectal ulcer just above the dentate line a year after brachytherapy for prostatic cancer. Biopsy of the ulcer was benign, but diverting colostomy was necessary because of non-healing.
One year after the colostomy, the patient developed fecaluria and urinary leakage per rectum. A colourethral fistula was demonstrated by retrograde urethrogram. The fistula burrowed through the central point of the perineum between the distal rectum and the prostatic and membranous portion of the urethra.
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