Robotic Genito-urinary

Fistula Repair
Comprehensive Consult

Keck Medicine of USC

Rene Sotelo, MD is one of the most experienced laparoscopic/robotic surgeons internationally. He is a
pioneer in robotic surgery for complex urinary fistulae in females and males and benign prostate enlargement.
He has helped develop the novel concepts of single-port belly-button and natural orifice surgery. His
experience with advanced robotic and laparoscopic surgery exceeds 2,300 personal cases, making him
amongst the most experienced in the world. He has published more than 50 peer reviewed scientific papers,
3 textbooks and 28 chapters in major urology books. He also serves on the editorial board of 3 urologic journals.
In recognition of his work, Dr. Sotelo has been invited as international guest-lecturer in more than 35 universities
in 19 countries. To date, he has trained over 64 post-graduate fellows from 14 countries in the art and science of
minimally invasive urology.

Leo Doumanian, MD is fellowship trained in urologic trauma and genitourinary reconstruction. He joined
USC after 5 years as Director of Genitourinary Trauma and Reconstruction at Temple University Hospital
in Philadelphia. Dr. Doumanian specializes in complex surgical management of traumatic, iatrogenic and
radiation-induced genitourinary injuries and congenital and acquired diseases of the lower urinary tract and
male genitalia. His particular interests include reconstruction of pelvic fracture urethral distraction defects
(PFUDD), urethral strictures, penile curvatures and rectourethral fistulae. Over the years, he has acquired
unique surgical skills for skin, lingual and buccal grafts, and advanced muscle and tissue flap transfers. These
innovative graft and flap techniques improve success, increase patient satisfaction and enhance cosmetic
outcomes in genitourinary reconstructive repair. Dr. Doumanian has been designated a reconstructive expert
and educator by International Volunteers of Urology (IVU).

Andreas M Kaiser, MD, FACS, FASCRS is a Professor of Clinical Surgery at USC. He is a Fellow of the
American College of Surgeons (FACS), the American Society of Colon and Rectal Surgeons (FASCRS), and a
member of several national and international professional associations and committees. He has extensive
experience in complex colorectal diseases. He provides comprehensive and interdisciplinary treatment in
the management of many challenging pathologies that may be beyond the scope of many other hospitals. He
specializes in the treatment and management of cancer of the colon/rectum, and benign diseases such as
inflammatory bowel disease (ulcerative colitis, Crohn’s disease), acute diverticulitis, colorectal fistulas, and
functional disorders. He is an expert in the latest technologies in robotic surgery, 3D-laparoscopic surgery, and
fecal incontinence. Dr. Kaiser is also highly specialized in implanting artificial bowel sphincters or magnetic rings
(Fenix). Dr. Kaiser has teamed up with Dr. Sotelo in providing highly expert, multi-disciplinary management of
genito-urinary fistulas in a comprehensive manner.

Associate Expert Faculty:

David Ginsberg, MD Evgeniy Kreydin, MD
Professor of Clinical Urology. Female Pelvic Assistant Professor of Clinical Urology. Female
Medicine and Reconstructive Surgery Pelvic Medicine and Reconstructive Surgery

Larissa Rodriguez, MD Kyle G. Cologne, MD, FACS, FASCRS

Professor of Clinical Urology. Female Pelvic Assistant Professor of Colorectal Surgery.
Medicine and Reconstructive Surgery Colorectal Surgery
Timing is crucial when dealing with genito-urinary fistulae. At Keck
Medicine of USC, we understand that patients facing this condition
have enormous anxiety and stress, with timing of treatment being
of critical significance. This includes the timing of diagnosis, work-
up, opinions, second opinions, previous management attempts
and definitive treatment. The logistics of consulting with multiple
specialists at different locations can become overwhelming, adding
undue stress to an already difficult clinical situation.
USC urologists have pioneered many of the surgical techniques to
repair this complex malady using the robot. The most common are
the recto-vesical fistulae (i.e., between the bladder and rectum), often
secondary to prostate or rectal surgery. Also common are vesico-
vaginal fistulae secondary to hysterectomy. To maximize chances of
treatment success, a surgeon experienced in surgical repair of fistulas,
bladder neck contractures and urethral stenosis (due to prostate
surgery, radiotherapy or focal therapies) is best suited to perform
these complex repairs.
At the USC Institute of Urology, our philosophy is “Patients First.”
Instead of patients having to make multiple appointments that can
encompass several weeks, we have established a novel program, the
“Robotic Genito-Urinary Fistula Repair Comprehensive Consult.”
What’s a fistula?
Fistulas are abnormal communications between two structures in the body, and are named by their anatomic
location as colovesical, rectovesical, vesicovaginal or rectourethral fistulas.
Rectourethral fistulas
are associated with benign
prostate surgeries and
energy treatments for
prostate cancer.
Housed within the USC Institute of Urology, we have created a multi-
disciplinary team approach to fistula treatment, providing our patients
with the latest research developments, technologies and expertise.
During this one-stop consultation visit, we bring together world-class
robotic urologic surgeons, general surgeons, colorectal surgeons and
reconstructive surgeons to ONE center.
This single, comprehensive evaluation allows for a collaborative
approach in dealing with genitourinary fistulas and brings the top
clinicians in their respective fields to you in personalized, comfortable
and friendly clinical surroundings. Here, all necessary investigations
are performed, your questions are answered and treatment plans are
finalized. You will leave knowing you have had the best options for a
cure explained, and clear treatment plans outlined.
If you would like to take advantage of the Robotic Genito-Urinary
Fistula Repair Comprehensive Consult here at the USC Institute of
Urology, please contact with María González at (323) 865-3753 or
Dr. René Sotelo at rene.sotelo@med.usc.edu to speak to one of our
Comprehensive Fistula team members.
Thank you for choosing Keck Medicine of USC for your
healthcare needs.
Rectovesical fistulas
are most frequently a
result of prostate or rectal
cancer procedures due
to inadvertent rectal
prostatic injuries.
In developed countries, the
majority of the Vesicovaginal
fistulas are related to
hysterectomies. Almost 100% are
associated to an obstetric cause.
USC INSTITUTE OF UROLOGY
The USC Institute of Urology provides the complete range of sub-specialties, delivering comprehensive diagnostic and
treatment services for the entire scope of urologic disorders. The institute comprises more than 27 full-time faculty and
more than 30 postgraduate residents and fellows, all committed to providing exceptional and innovative patient care
and research to advance the field.

KECK MEDICINE Of USC

Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-based
medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical
system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC,
the region’s first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first
comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical
faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care
hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC
Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some
at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties.

USC Institute of Urology

Service Locations:
USC Institute of Urology – Norris Healthcare
Center (HC3)
1516 San Pablo Street, 5th floor, Suite 3500,
Los Angeles, CA 90033
(323) 865–3700, option 1
800-USC-CARE (800-872-2273)

Verdugo Hills Hospital

1808 Verdugo Boulevard, Suite 318
Glendale, CA 91208
(818) 790–1278
800-USC-CARE (800-872-2273)

USC Institute of Urology – Montebello

2133 West Beverly Boulevard, Suite 200
Montebello, CA 90640
(626) 701–8601
800-USC-CARE (800-872-2273)

Keck Medicine of USC

BEYOND EXCEPTIONAL MEDICINE™