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Why is it done?

  • Bladder intestinal fistula is an abnormal communication between bladder and bowel.
  • Many causes:

Previous surgery
Diverticular disease
Colonic cancers

  • This procedure is performed when all other treatment options are exhausted with recurrent symptoms and persistent Pnematuria and fecaluria due to a colonic-vesical fistula
  • Symptoms include: Pneumaturia (air in urine), Faecaluria (stool in Urine, recurrent bladder infections.
  • This surgery is usually done with a Colo-rectal surgeon and may involve a partial bowel resection, possibly a temporary loop ileo/colostomy (diversion of bowel with an external bag)


How is it done?

  • Patients will receive a general anaesthesia,  unless contra-indicated.
  • Prophylactic antibiotics are given.
  • An indwelling catheter is placed and the bladder is filled with saline.
  • A lower midline incision is made.
  • The retropubic space of Retzuis is entered
  • The bladder is resected away from the bowel.
  • The affected piece of bowel may be resected with either a temporaru diversion of the bowel to a bag or a primary anastomosis depending on the colo-rectal surgeon’s findings
  • The affected part of the bladder may be resected. The bladder is closed in 2 layers over a 3-way irrigation catheter
  • Omentum will be placed between bladder and bowel where at all possible to limit recurrences
  • A drain is left for a couple of days
  • You may have continuous Antibiotics over the next few days.
  • You have a few days stay in ICU or high care facility




  • Rarely blood loss requiring a blood transfusion.
  • Infection/ sepsis
  • Prolonged hospital stay.
  • Urine leak requiring prolonged catheterisation.
  • Bowel leak etc
  • NB! Each person is unique and for this reason symptoms vary!.


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Copyright 2019 Dr. Jo Schoeman