Why is it done?
- Bladder intestinal fistula is an abnormal communication between bladder and bowel.
- Many causes:
- 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!.
Copyright 2019 Dr. Jo Schoeman