Sharma, ArindamKurtz, MichaelEswara, Jairam R.2014-05-062014Sharma, Arindam, Michael P. Kurtz, and Jairam R. Eswara. 2014. “Three Distinct Urethral Fistulae 35 Years After Pelvic Radiation.” Nephro-urology Monthly 6 (2): e14197. doi:10.5812/numonthly.14197. http://dx.doi.org/10.5812/numonthly.14197.2251-7006http://nrs.harvard.edu/urn-3:HUL.InstRepos:12152851Introduction: 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.en-USRadiation InjuriesRhabdomyosarcomaSurgical FlapsUrinary DiversionUrinary FistulaJournal Article2014-05-0610.5812/numonthly.14197