Vesicocolic Research Articles

Laparoscopic treatment of a vesicointestinal fistula due to a Meckel’s diverticulum: a case report and review of the literature

While there have been numerous reports about colovesical fistulas and ruptured intestinal diverticula, there have been far fewer reports about vesicointestinal fistulas caused by Meckel's diverticula. Most Meckel's diverticula are asymptomatic. Furthermore, they seldom cause vesicointestinal fistulas, and the associated complications are non-specific. Thus, their preoperative diagnosis is difficult. We experienced a case in which a vesicointestinal fistula was caused by a Meckel's diverticulum and was treated with laparoscopic surgery. A 46-year-old male was referred to our hospital after exhibiting hematuria. Cystoscopy revealed a fistula between the small intestine and bladder. Contrast-enhanced computed tomography and magnetic resonance imaging showed a diverticulum in the ileum and a fistula between the ileum and bladder, which passed through the diverticulum. A Meckel's diverticulum was suspected. We conducted a laparoscopic operation. We dissected the Meckel's diverticulum with an automatic suturing device and removed it together with part of the ileum. The patient's postoperative course was good. We experienced a case in which a vesicointestinal fistula was caused by a Meckel's diverticulum and was successfully treated with laparoscopic surgery. In selected cases of Meckel's diverticulum, the dissection of the diverticulum with an automatic suturing device is appropriate.

Presentation of an ingested foreign body as a vesical calculus

Vesical calculus is a common entity in children of developing countries. Foreign body ingestion is a common occurrence in the pediatric population. An ingested foreign body eroding into the urinary bladder and leading to the formation of a vesical calculus is an extremely rare condition. We encountered a 14-year-old girl who presented with a vesical calculus and a history of ingestion of a nut bolt 7 years earlier. After cystolithotomy and retrieval of the calculus, we noticed that the nut bolt formed its core. As it is an extremely uncommon presentation, it is being reported here, with a brief review of the literature. Keywords: foreign body calculus, foreign body ingestion, vesical calculus, vesicointestinal fistula

A case of vesicointestinal fistula implicated in bladder diverticulum associated with consciousness disturbance

A case of vesicointestinal fistula implicated in bladder diverticulum associated with consciousness disturbance

Feasibility of Surgery After Systemic Treatment with the Humanized Recombinant Antibody Bevacizumab in Heavily Pretreated Patients with Advanced Epithelial Ovarian Cancer

The aim of this study was to assess operative feasibility and outcome after bevacizumab treatment (BT) in ovarian cancer (OC) patients. We retrospectively identified all OC patients operated between April 2006 and September 2010 after BT. We identified 733 OC operations, 10 of which (1.36%) were performed in a mean time of 134days (range, 10-288) after BT. Indication was secondary cytoreduction in 3 patients (mean days after BT, 181; range, 82-256) and palliation in 7 due to bowel obstruction and/or intestinal perforation or fistula (mean days after BT, 114; range, 10-288). All but 1 acutely operated patients developed a secondary wound healing, but none of the 3 patients after planned cytoreduction did. Of these 3 patients, 1 suddenly died on the 36th postoperative day, presumably of thromboembolism. None of the patients developed postoperatively a gastrointestinal morbidity; however, in 1 patient operated 21days after BT due to a vesicointestinal fistula the bladder reconstruction could not heal and developed a permanent fistula. Emergency surgery after BT due to bowel obstruction and/or fistulas seems to be associated with an impaired wound healing in advanced heavily pretreated platinum-resistant OC patients, while this does not appear the case in planned cytoreduction. Prospective evaluations are warranted to assess surgical safety after BT in this special patients' collective.

Completely Separated Scrotum and Vesicointestinal Fistula Without Exstrophy as a Novel Manifestation of Aphallia: A Case Report

A male infant born at 32 weeks of gestation and weighing 1.44 kg had penile agenesis, bifid scrotums, an anorectal anomaly, and suspected omphalocele. An operation revealed complete urethral agenesis, duplicated and blind bowels, a vesicointestinal fistula without exstrophy, and a urachal fistula; however, no omphaloceles were detected. To our knowledge, this is the first report on aphallia accompanied with completely separated scrotum and a vesicointestinal fistula without exstrophy; this condition is associated with urorectal septum malformation sequence (URSMS) and covered cloacal exstrophy. The possible embryogenesis is discussed in this study.

Vesico-intestinal Fistulae and Recto-urethral Fistulae1

Summary 23 cases of urinary intestinal fistulae are presented: vesico-intestinal fistulae, 9 cases; ureterointestinal fistulae, 2 cases; urethro-rectal fistulae, 12 cases. Out of the 11 operations for urethrorectal fistulae, 2 were unsuccessful. All the urethro-rectal fistulae were repaired by the Whitehead-Young-Stone method, which the author recommends.

Manifestation, Latency and Management of Late Urological Complications after Curative Radiotherapy for Cervical Carcinoma

Background: Radiotherapy alone or in combination with radical hysterectomy remains a potentially curative treatment for cervical carcinoma. Late urological complications after curative radiotreatment are rare but often present difficult problems of management due to the progressive nature of radiogenic tissue damage. We reviewed all cases of radiogenic urologic complications after radiotherapy for cervical carcinoma treated at our institution over the past 10 years. Patients and Methods: In a retrospective analysis, out of all female patients treated for hydronephrosis (n = 543), 93 patients with hydronephrosis occurring after curative treatment for gynecological malignancies were identified. The most frequent cause was progressive disease (n = 55); 30 patients without recurrence had severe radiogenic urological complications (study population). Results: Out of 30 patients with a mean age of 44.9 years at the time of treatment for cervical cancer, 6 had undergone primary radiotherapy and 24 had received adjuvant radiotreatment after radical hysterectomy. The observed late urological complications were: distal ureteral stenoses (bilateral in 4 cases, unilateral in 15 cases), distal ureteral necrosis (n = 1), bilateral ureteral reflux (n = 3), vesico-vaginal fistulae (n = 5), vesico-intestinal fistula (n = 1), severe fibrotic bladder shrinkage (n = 6) and urethral stenosis (n = 2). Marked signs of radiogenic cystitis were observed in almost all patients. The mean latency time between radiotherapy and manifestation of severe radiogenic urological sequelae was 19.4 years (range 0.5–41.5). Primary treatment of urological complications consisted in temporary urinary diversion by percutaneous nephrostomies or insertion of internal ureteral stents. Permanent treatment for radiogenic ureteral stenosis in all patients with sufficient general health consisted of surgical or endourological urinary diversion or reconstruction. However, the majority of patients were managed by permanent endourological measures. Lower tract fistulae were treated by distal ureteral occlusion and diversion. Conclusions: Although severe late urological sequelae of curative radiotherapy for cercvical carcinoma are rare they represent major complications, result in considerable distress for the patient, and often present difficult therapeutic problems for the urologist. As these urological complications can have extremely long latency times, focussed follow-up for early detection may be advisable.

PENILE AGENESIS WITH A SEPARATED SCROTUM AND NORMAL RENAL FUNCTION IN AN IDENTICAL TWIN

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Feb 2002PENILE AGENESIS WITH A SEPARATED SCROTUM AND NORMAL RENAL FUNCTION IN AN IDENTICAL TWIN JUSTIN E. WITTKOPF, CHRISTOPHER S. COOPER, and CHARLES E. HAWTREY JUSTIN E. WITTKOPFJUSTIN E. WITTKOPF More articles by this author , CHRISTOPHER S. COOPERCHRISTOPHER S. COOPER More articles by this author , and CHARLES E. HAWTREYCHARLES E. HAWTREY More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)69126-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "PENILE AGENESIS WITH A SEPARATED SCROTUM AND NORMAL RENAL FUNCTION IN AN IDENTICAL TWIN." The Journal of Urology, 167(2 Part 1), pp. 687–688 References 1 : Diagnosis and current management of penile agenesis. J Pediatr Surg1998; 33: 628. Crossref, Medline, Google Scholar 2 : Agenesis of the penis, scrotal raphe and anus in one of monoamniotic twins. Teratology1984; 29: 173. Crossref, Medline, Google Scholar 3 : Agenesis of the penis: patterns of associated malformations. Am J Med Genet1999; 84: 47. Crossref, Medline, Google Scholar 4 : Persistent cloaca with absent penis and anal atresia in one of identical twins. J Pediatr1978; 93: 821. Crossref, Medline, Google Scholar From the Children's Hospital of Iowa, Division of Pediatric Urology, Iowa City, Iowa© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Luo S, Yang Z, Ma N, Wang W, Chen S, Wu Q, Qu S and Li Y (2022) Congenital aphallia associated with congenital urethrorectal fistulaMedicine, 10.1097/MD.0000000000028878, VOL. 101, NO. 7, (e28878) Demirer Z, Aip B, Uguz S, Guragac A and Irkilata H (2015) A rare case of penis agenesis (Aphallia) with associated multiple urogenital anomaliesInternational Journal of Surgery Case Reports, 10.1016/j.ijscr.2015.08.004, VOL. 15, (10-12), . Nakano Y, Aizawa M, Honma S and Osa Y (2009) Completely Separated Scrotum and Vesicointestinal Fistula Without Exstrophy as a Novel Manifestation of Aphallia: A Case ReportUrology, 10.1016/j.urology.2009.04.055, VOL. 74, NO. 6, (1303-1305), Online publication date: 1-Dec-2009. Goenka A, Jain V, Sharma R, Gupta A and Bajpai M (2008) MR diagnosis of penile agenesis: is it just absence of a phallus?Pediatric Radiology, 10.1007/s00247-008-0910-1, VOL. 38, NO. 10, (1109-1112), Online publication date: 1-Oct-2008. Srinivasan J, McDougall P and Hutson J (2003) When is 'intersex' not intersex? A case of penile agenesis demonstrates how to distinguish non-endocrine disorders in neonates with genital anomalyJournal of Paediatrics and Child Health, 10.1046/j.1440-1754.2003.00249.x, VOL. 39, NO. 8, (629-631), Online publication date: 1-Nov-2003. Volume 167Issue 2 Part 1February 2002Page: 687-688 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.KeywordsabnormalitiesscrotumpenistwinsMetricsAuthor Information JUSTIN E. WITTKOPF More articles by this author CHRISTOPHER S. COOPER More articles by this author CHARLES E. HAWTREY More articles by this author Expand All Advertisement PDF downloadLoading ...

Diagnosis of vesico-intestinal fistulas by contrast medium enhanced 3-D ultrasound

Standard diagnostic tools for vesico-intestinal fistulas are cystoscopy, cystography, colonoscopy, and contrast enema. The aim of our study was to evaluate the efficacy of transrectal 3D-ultrasound with contrast media in these patients. From 5/98 to 12/99 we examined 10 patients with symptoms of a vesico-intestinal fistula (pneumaturia, faecaluria). After placement of a transurethral catheter a transabdominal ultrasound examination (Kretz Combison 530) was performed with the bladder half full to evaluate the bladder wall. Then the bladder was filled with diluted ultrasound contrast media (Levovist 40 mg/ml) to visualize the flow from the bladder towards the fistula. To verify a flow through the bladder wall a colour Doppler sonography of the region of interest was added. To evaluate form and extent of the fistula a transrectal ultrasound with 3D-image assessment was performed. Using this technique it was possible to demonstrate a vesico-intestinal fistula in 9 of 10 patients. In all cases these findings were confirmed by the standard diagnostic procedures. The fistulas were caused by: bladder carcinoma (n = 1), carcinoma of the colon (n = 2), Crohn's disease (n = 3) and diverticulitis of the sigma (n = 3). One patient presented with a neovesico-intestinal fistula in an irradiated local recurrence of bladder carcinoma. In one patient with Crohn's disease whose only symptom was pneumaturia all diagnostic tools failed to provide the diagnosis. For the first time vesico-intestinal fistulas could be demonstrated by ultrasound with 3D-image assessment using contrast media. This technique might be an effective addition to the standard diagnostics of vesico-intestinal fistulas reducing the exposure to radiation.

VESICOINTESTINAL FISTULA AFTER COMBINED ILEAL AND GASTRIC BLADDER AUGMENTATION

Bladder augmentation with mixed enteric segments is being used with increasing frequency. In addition, the use of stomach has been reported to result in fewer electrolyte abnormalities, less stone formation, decreased mucous production and decreased incidence of urinary tract infections. However, the disadvantage of using stomach for composite bladder augmentation, most notably the hematuria-dysuria syndrome, has placed it in disfavor at many institutions. We report a case of vesicointestinal fistula after combined ileal and gastric bladder augmentation.

A CASE OF VESICOINTESTINAL FISTULA DUE TO DIVERTICULITIS OF THE ILEUM

A 75-year-old woman was seen at the hospital because of fecaluria. Cystoscopy revealed an opening suspecting of fistula orifice at the top of the cyst. Cystography visualized an influx of contrast medium from fistula orifice into the ileus. Abdominal CT revealed not tumor image. With barium enema there were any findings suggestive of malignant colorectal tumor. From the above, the patient was diagnosed as having a vesicoileal fistula and partial ileocystectomy was carried out. In the resected ileum multiple diverticula were noted; one of those diverticula formed a fistula with the cyst; and another diverticulum perforated into the cyst. Histologically the presence of diverticula was also confirmed. It was thought that patient had a vesicointestinal fistula caused by diverticulitis of the ileum.

Report on Cases of Vesicointestinal Fistulae due to Crohn's Disease

Report on Cases of Vesicointestinal Fistulae due to Crohn's Disease

Optimal Management of Cloacal Exstrophy

Classic management of cloacal exstrophy has emphasized primary closure of the omphalocele, end ileostomy, and delayed genitourinary reconstruction. The resultant mortality from and urinary sepsis, and morbidity from inappropriate gender assignment has prompted us to reexamine the operative approach to this problem. Our experience involves 15 cases from 2 days to 21 years after repair. All had initial closure of their omphalocele. Nine of the 15 had closure of the vesicointestinal fistula with preservation of the distal colon segment and creation of an end colostomy; 2 had an initial ileostomy with later conversion to an end colostomy; and 2 have permanent ileostomies. Nine of the 15 were genetic males; six were converted to female, five during the newborn period and one at 9 months. The hemibladders were approximated in 13 of 15 and two had a primary turn-in of the exstrophied bladder. Three had bladder closure with iliac osteotomies delayed beyond the newborn period. Urinary diversion has been utilized in 11 patients, 7 ileal conduits, 1 vesicostomy, 2 cutaneous ureterostomies, and 2 temporary pyelostomies; only one patient remains with an exstrophied bladder. Three patients with closure of the bladder remain incontinent. Of our patients, 13 of 15 are alive and well. One died at age 2 days because of renal agenesis and one was 19 years old when found dead of an unknown cause. There have been no deaths due to short-bowel syndrome or sepsis, and no patients have had upper urinary-tract deterioration. These results prompt us to recommend the following therapy for cloacal exstrophy: (1) early closure of the omphalocele; (2) closure of the vesicointestinal fistula with creation of an end colostomy at the distal end of the blind pouch; (3) reapproximation of the hemibladders; and (4) gender assignment to female. Subsequent procedures in the stable infant would include bladder closure and later reconstruction for continence if the bladder is suitable or appropriate permanent diversion.

Optimal management of cloacal exstrophy

Classic management of cloacal exstrophy has emphasized primary closure of the omphalocele, end ileostomy, and delayed genitourinary reconstruction. The resultant mortality from and urinary sepsis, and morbidity from inappropriate gender assignment has prompted us to reexamine the operative approach to this problem. Our experience involves 15 cases from 2 days to 21 years after repair. All had initial closure of their omphalocele. Nine of the 15 had closure of the vesicointestinal fistula with preservation of the distal colon segment and creation of an end colostomy; 2 had an initial ileostomy with later conversion to an end colostomy; and 2 have permanent ileostomies. Nine of the 15 were genetic males; six were converted to female, five during the newborn period and one at 9 months. The hemibladders were approximated in 13 of 15 and two had a primary turn-in of the exstrophied bladder. Three had bladder closure with iliac osteotomies delayed beyond the newborn period. Urinary diversion has been utilized in 11 patients, 7 ileal conduits, 1 vesicostomy, 2 cutaneous ureterostomies, and 2 temporary pyelostomies; only one patient remains with an exstrophied bladder. Three patients with closure of the bladder remain incontinent. Of our patients, 13 of 15 are alive and well. One died at age 2 days because of renal agenesis and one was 19 years old when found dead of an unknown cause. There have been no deaths due to short-bowel syndrome or sepsis, and no patients have had upper urinary-tract deterioration. These results prompt us to recommend the following therapy for cloacal exstrophy: (1) early closure of the omphalocele; (2) closure of the vesicointestinal fistula with creation of an end colostomy at the distal end of the blind pouch; (3) reapproximation of the hemibladders; and (4) gender assignment to female. Subsequent procedures in the stable infant would include bladder closure and later reconstruction for continence if the bladder is suitable or appropriate permanent diversion.

Vesicointestinal fissure revisited

This complicated anomaly of bladder exstrophy, intestinal fistula, and various degrees of colonic atresia with imperforate anus is readily recognizable. The long-term result of conventional management has been disappointing. Fecal and urinary incontinence have been unavoidable and a source of disappointment to patients and parents. An alternative method of total management is detailed. This variation of management may result in earlier and more complete social acceptability of the child so afflicted. At as young an age as possible, the vesicointestinal connection is detached and the bladder defect as well as the intestinal opening closed. The short colon is freed and transected at its midpoint. The right half of the colon is brought out through a separate wound as a colostomy. The distal half of the divided colon is brought out as mucous fistula on the left. This distal colonic segment is the proposed future colonic loop for urinary diversion to be fashioned in the first year of life. The exstrophied bladder is removed at a later date. Epispadias in the male may be repaired later. A Pediatric Ostomy Club has been organized to include a pediatric stomal therapist and involved nurses and physicians. The group gives the parents advice and moral support. We believe that this approach will permit the child to go to school and carry on relatively normal activity and to be socially acceptable. An overview of our total experience in the management of 25 patients with vesicointestinal fistula details the result in 9 surviving patients.

Urological complications in chronic inflammatory diseases of the bowel.

In advanced stages, the three most common inflammatory bowel diseases - colonic diverticulitis, Crohn's disease and ulcerative colitis - cause, in some 10% of cases, secondary urological pathology involving either bladder or ureter. Colovesical fistula is found more frequently in diverticulitis and less often in Crohn's disease, which penetrates predominantly from the ileum into the bladder. On the other hand, if uretic stenosis develops it will be caused on the right side by Crohn's disease and on the left by ulcerative colitis. Vesico-intestinal fistulae will close without sequelae after resection of the diseased bowel segment. On the other hand, retroperitoneal ureteric stenosis - despite bowel resection and ureterolysis - will often require nephrectomy if operation is not carried out early enough. Frequent re-checks with infusion excretory urography will help to prevent this. Nephrolithiasis, amyloidosis and contracted bladder are other, though less common, complications of chronic inflammatory diseases of the bowel.

Vesico-intestinal fistulae

Vesico-intestinal fistulae were observed in 14 patients within a period of 10 years (vesico-colonic: ten; vesico-rectal: two; vesico-ileal and vesico-rectal-ileal: one each). The causes were diverticulitis in five, carcinoma of the sigmoid in two, radiation damage after prostatic or cervical carcinoma in two, and Crohn's disease, abscess of Douglas's pouch after perforated appendicitis, ileal carcinoma, sarcoma of the pelvis, and ovarian carcinoma, one each. Pneumaturia, faecaluria and dysuria were the most frequent symptoms, treatment-resistant cystitis was present in three. Cystoscopy, intravenous pyelogram, retrograde cystogram, barium meal, barium swallow with follow-through, and rectosigmoidoscopy proved to be the best methods of diagnosis. Four patients had multiple operations, three one operation, with a cure in all. In the neoplastic fistulae the underlying carcinoma could not be radically operated on: colostomy or colostomy with palliative resection was performed. In four of these the fistulae then closed, once it remained open. One woman with a vesicorectal fistula due to ovarian carcinoma died of tumor cachexia 16 days after a colostomy had been made.

Vesico-intestinal fistulae and recto-urethral fistulae.

Summary 23 cases of urinary intestinal fistulae are presented: vesico-intestinal fistulae, 9 cases; ureterointestinal fistulae, 2 cases; urethro-rectal fistulae, 12 cases. Out of the 11 operations for urethrorectal fistulae, 2 were unsuccessful. All the urethro-rectal fistulae were repaired by the Whitehead-Young-Stone method, which the author recommends.

Vesico-intestinal fistulae.

Abstract Vesico-intestinal fistulae carry a serious prognosis by the nature of the underlying pathology. The inflammatory lesions offer the best hope for surgery and the necessity for early radical surgery in this group is stressed. The clinical details of 74 cases of vesico-intestinal fistulae are given together with their investigations, treatment, and results. The improved results over the past 10 years appear to bear out the necessity for early treatment.

ON THE PATHOLOGY AND BEHAVIOUR OF ACQUIRED NON-TRAUMATIC VESICO-INTESTINAL FISTULA.

ON THE PATHOLOGY AND BEHAVIOUR OF ACQUIRED NON-TRAUMATIC VESICO-INTESTINAL FISTULA.