Introduction: While the development of fistulae is a well-known complication of radiotherapy, such fistulae can often be challenging to manage.
Case presentation: We describe the case of a 37 year old male who developed in succession a urethrocutaneous fistula to the thigh, a rectourethral fistula and a peritoneo-urethral fistula 35 years after radiotherapy for pediatric pelvic rhabdomyosarcoma. These complications were managed successfully after multiple surgical procedures.
Discussion: We subsequently discuss the different approaches currently employed for the management of radiation induced urinary fistulas and describe the rationale behind our approach towards their surgical management.
Keywords: Radiation Injuries; Rhabdomyosarcoma; Surgical Flaps; Urinary Diversion; Urinary Fistula.