Rectal ulceration and rectourethral fistula as rare complications of radiotherapy for prostate cancer — a case report and literature review

We present a case of a patient with inoperable prostate cancer [Gleason 10 (5 + 5), cT3b]. The patient was treated with radical radiotherapy because he had numerous internal conditions, and he had been disqualified from radical prostatectomy. The man developed radiation colitis after radiotherapy. This inflammation led to rectal ulceration. Another complication of radical irradiation was a rectourethral fistula. In this case, the reaction occurred within 6 months of the initiation of irradiation, i.e. during the period of early effect, whereas the presentation of the reaction (ulcer, fistula) corresponded to the late effect. This led us to classify the presented case as a consequential late effect. This article presents possible complications and treatment options for prostate radiotherapy. We reviewed the available literature and discussed our patient’s case in the context of other authors’ experiences.