What Is a Leaky Bladder?
Bladder fistula means that urine is partly or completely excreted through abnormal channels of the bladder or excreted through other organs in the body. Bladder fistula includes bladder vaginal fistula, bladder bowel fistula, bladder rectal fistula, bladder uterine fistula and bladder skin fistula. Among them, bladder vaginal fistula caused by dystocia is the most common.
- Chinese name
- Bladder fistula
- Foreign name
- vesical fistula
- Bladder fistula means that urine is partly or completely excreted through abnormal channels of the bladder or excreted through other organs in the body. Bladder fistula includes bladder vaginal fistula, bladder bowel fistula, bladder rectal fistula, bladder uterine fistula and bladder skin fistula. Among them, bladder vaginal fistula caused by dystocia is the most common.
Causes of bladder fistula and common diseases
- The first cause is abdominal and pelvic surgical injury, especially malignant tumor-related surgery. It is also seen in prostatic hyperplasty, bladder neck wedge resection, hysteromyoma, cesarean section, and pelvic schwannoma resection. In the rectum. Followed by malignant tumor invasion, including colon cancer, rectal cancer, and malignant lymphoma. Then came chronic infections and inflammation, including Crohn's disease, celiac tuberculosis, chronic appendicitis, chronic umbilical infection, and abdominal infection after kidney transplantation. There are also bladder foreign bodies (contraceptive devices), vaginal mediastinum, and congenital cervical bladder fistula. Bladder fistulas caused by non-surgical injuries involve the sigmoid colon most.
Differential diagnosis of bladder fistula
- Feces, urination, gross hematuria, urinary tract irritation, abdominal pain / bloating, abdominal masses, watery stools, vaginal drainage, increased pelvic or abdominal drainage, periodic gross hematuria with menstruation, etc.
Bladder fistula
- The auxiliary examination can not only clarify the existence of the fistula, but also help to find the cause of the fistula and the anatomical relationship of the local lesions, and provide a basis for formulating a surgical plan. CT is now the preferred method of examination. It is highly sensitive in diagnosing bladder fistulas and has a good resolution for abdominal pelvic mass lesions, abscesses, and colonic diverticulitis. Three-dimensional reconstruction CT and MRI are better than ordinary CT, but the equipment is expensive, which limits their clinical application. Both cystoscopy and cystography have a high positive detection rate of fistula. Color Doppler ultrasound has a low positive rate for fistula diagnosis, but can detect bladder or abdominal mass lesions. Bowel tumors are a common cause of bladder fistulas, so colonoscopy is very useful, although the fistula is rarely seen. Barium meal imaging is also helpful in diagnosis, especially small bowel bladder fistula or small bowel-small bowel fistula. Meilan test, Bourne test and oral charcoal test can confirm the existence of fistula, but can not determine the location and cause of fistula. Intravenous pyelography, plain radiographs, and isotope renal blood maps have no diagnostic value.
Bladder fistula treatment principles
- This disease is a rare surgical disease, but before diagnosis, it is often seen in internal medicine with symptoms of the urinary system or digestive system, which is easy to miss or misdiagnose. The literature report delays the diagnosis by an average of 11 months.
- Surgical treatment, surgical methods: bladder fistula removal / repair; bladder fistula removal / repair + proximal intestinal fistula; bladder fistula resection / repair + bladder ostomy.
- Non-surgical treatment, including fasting, intravenous nutrition, continuous catheterization, and antibiotic use.