Q. My husband has a bladder fistula formed from Crohn's disease. How to manage it?
Hi doctor,
My husband has Crohn's disease and a bladder fistula is formed from it. His bowel is tunneling into the bladder. What is the surgery done for this problem? Does it require a bag as it involves the bowel? Can the bladder be sewed? Will it cause damage to the bladder? How long a urinary catheter should be placed after surgery? How to check and when it needs to be checked to know whether the surgery is effective?
Hi,
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Enterovesical fistula formed due to Crohn's disease is treated therapeutically with the help of antibiotics, steroids, and cytostatics. Catheters are used for urinary drainage and parenteral feeding. This is the preferred way of treatment. Surgical treatment is preferred in cases of abscess, urine obstruction, compound fistula, cancer, and when the therapeutic treatment fails. Intestine resection and bladder repair are performed without taking the help of diverting intestinal transit or urinary bag. These manipulations are used in advanced cases. Catheterization of the bladder is followed for three to four weeks. So an accurate diagnosis and evaluation from a general surgeon are needed. A urologist is required to decide the method of treatment.
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