What happens when the bladder has abnormal connections with other organs? The information below should help you recognize this problem before it causes serious damage.
What is bladder fistula?
Bladder fistula refers to an abnormal connection between the bladder and another organ or the skin. Most commonly this involves the bowel (enterovesical fistula) or the vagina (vesicovaginal fistula). Although relatively rare, fistulization to the skin can result from an injury or previous surgery in the face of bladder outlet obstruction. Vesicovaginal fistulas are seen after a urologic or gynecological surgery or in relation to gynecological cancers. Fistulas to the bowel are most commonly seen as a result of inflammatory bowel disease such as Crohn’s disease or diverticulitis. About 20 percent of bowel fistulas are caused by bowel cancer. Fistulas are rarely caused by bladder pathology. Fistulas to both the vagina and the bowel may also develop as a result of previous radiation therapy.
Symptoms are frequent urinary tract infections or the passage of gas from the urethra during urination.
How is bladder fistula diagnosed?
Bladder fistula is diagnosed by the use of an excretory urogram, which is an X-ray examination of the bladder. An excretory urogram study uses a contrast dye to enhance the X-ray images. The dye is injected into the patient’s system, and its progress through the urinary tract is then recorded on a series of quickly captured images. The examination enables the radiologist to review the anatomy and the function of the bladder and urinary tract.
How is bladder fistula treated?
Treatment of bladder fistula usually requires partial surgical removal. If it is caused by a disease such as colon cancer or inflammatory disease, surgical removal is usually done in conjunction with removal of the primary disease.
The success of surgery is directly related to the ability to remove the primary disease and the presence of healthy tissue with which the fistula is closed. Ideally, healthy tissue with good blood supply is brought between the bladder and the other organ. The presence of unremovable cancer or tissue exposed to radiation and having a bad blood supply make a good result more difficult to obtain. The patient can expect to have a catheter in their bladder for a few weeks postoperatively.