Use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula

Dear Author, I read with interest the letter by Deepak Batura about our paper entitled Use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula. I thank the colleague for his accurate comments. I take this opportunity to clarify the following points: 1.All 7 patients reported in the original article underwent double diversion at least 2 months before the author’s procedure. In this situation, no enteric preparation is necessary with a surgical field clean and ideal to use a mesh in a potential infected site. The biological mesh has a great capacity to progressively integrate itself; 2.All 7 patients we described underwent extensive clinical investigations during serial follow-up visits that excluded urethral stricture, signs of infections or urethral sequelae. That’s way the patients did not undergo extra exams (endoscopic or bacteriological) once the stoma was closed; I hope this additional information will help to clarify up your queries