{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:30:29Z","timestamp":1771061429659,"version":"3.50.1"},"reference-count":10,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,21]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>We present three male patients who had a rare presentation of anal fistula reaching the genital tract. Patient 1: a 44-year-old diabetic man presented initially to urology clinic complaining of penile and scrotal masses increasing in size for 6 months. Patient 2: a 67-year-old diabetic man presented with chronic sinus discharge from the scrotum. Patient 3: a 37-year-old diabetic man who presented with chronic sinus draining pus-like material from the scrotum for 1\u2009year. Patients 1 and 2: following diagnosis of perianal fistula by MRI fistulography, complete excision of the fistula was done. This required tracking the fistula surgically, a perineal midline incision to release the fistula and excision of the fistula opening in the anal canal. The patients were doing well postoperative and no recurrence of fistula at 1-year follow-up. Patient 3: he refused surgical intervention. Penile mass or scrotal discharge has not been reported to be caused by fistula-in-ano.<\/jats:p>","DOI":"10.1136\/bcr-2019-231702","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T15:36:29Z","timestamp":1571844989000},"page":"e231702","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Complex anal fistula involving male genital tract: a new diagnostic entity"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8936-3179","authenticated-orcid":false,"given":"Abdullah","family":"Alahmari","sequence":"first","affiliation":[{"name":"Department of Urology, King Abdulaziz University Faculty of Medicine, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majed","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amjad","family":"Alwaal","sequence":"additional","affiliation":[{"name":"Department of Urology, Marshall University, Huntington, West Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,10,23]]},"reference":[{"key":"2025082703194064000_12.10.e231702.1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s10151-013-1111-y","article-title":"Risk factors for anal fistula: a case-control study","volume":"18","author":"Wang","year":"2014","journal-title":"Tech Coloproctol"},{"key":"2025082703194064000_12.10.e231702.2","doi-asserted-by":"crossref","first-page":"092","DOI":"10.1055\/s-0036-1580631","article-title":"Management of complex perineal fistula disease","volume":"29","author":"Akiba","year":"2016","journal-title":"Clin Colon Rectal Surg"},{"key":"2025082703194064000_12.10.e231702.3","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s13244-010-0022-y","article-title":"MRI for assessment of anal fistula","volume":"1","author":"Torkzad","year":"2010","journal-title":"Insights Imaging"},{"key":"2025082703194064000_12.10.e231702.4","doi-asserted-by":"publisher","DOI":"10.1148\/rg.321115040"},{"key":"2025082703194064000_12.10.e231702.5","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1055\/s-0035-1570392","article-title":"Management of complex anal fistulas","volume":"29","author":"Bubbers","year":"2016","journal-title":"Clin Colon Rectal Surg"},{"key":"2025082703194064000_12.10.e231702.6","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1308\/rcsann.2016.0136","article-title":"Quality of life with anal fistula","volume":"98","author":"Owen","year":"2016","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082703194064000_12.10.e231702.7","doi-asserted-by":"publisher","DOI":"10.1007\/BF02058706"},{"key":"2025082703194064000_12.10.e231702.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-016-0604-z","article-title":"Imperforate anus with rectopenile fistula: a case report and systematic review of the literature","volume":"16","author":"Yang","year":"2016","journal-title":"BMC Pediatr"},{"key":"2025082703194064000_12.10.e231702.9","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jviscsurg.2013.08.002","article-title":"Treatment of recurrent rectovaginal\/pouch-vaginal fistulas by gracilis muscle transposition\u00a0-\u00a0a single center experience","volume":"150","author":"Troja","year":"2013","journal-title":"J Visc Surg"},{"key":"2025082703194064000_12.10.e231702.10","first-page":"17","article-title":"Penile abscess: a case report and review of literature","volume":"2","author":"Garcia","year":"2014","journal-title":"Urol Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231702","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:19:50Z","timestamp":1756289990000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231702"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,10,23]]},"published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1136\/bcr-2019-231702"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231702","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}