Bladder Fistula

What happens when the bladder has abnormal connections with other organs? The information below should help you recognize this problem before it causes serious damage.

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What is bladder fistula?

Bladder fistula refers to an abnormal connection between the bladder and another organ or the skin. Most commonly this involves the bowel (enterovesical fistula) or the vagina (vesicovaginal fistula). Although relatively rare, fistulization to the skin can result from an injury or previous surgery in the face of bladder outlet obstruction. Vesicovaginal fistulas are seen after a urologic or gynecological surgery or in relation to gynecological cancers. Fistulas to the bowel are most commonly seen as a result of inflammatory bowel disease such as Crohn's disease or diverticulitis. About 20 percent of bowel fistulas are caused by bowel cancer.  Fistulas are rarely caused by bladder pathology. Fistulas to both the vagina and the bowel may also develop as a result of previous radiation therapy.

Symptoms are frequent urinary tract infections or the passage of gas from the urethra during urination.

Bladder fistula is diagnosed by the use of an excretory urogram, which is an X-ray examination of the bladder. An excretory urogram study uses a contrast dye to enhance the X-ray images. The dye is injected into the patient's system, and its progress through the urinary tract is then recorded on a series of quickly captured images. The examination enables the radiologist to review the anatomy and the function of the bladder and urinary tract.

Treatment of bladder fistula usually requires partial surgical removal. If it is caused by a disease such as colon cancer or inflammatory disease, surgical removal is usually done in conjunction with removal of the primary disease. 

The success of surgery is directly related to the ability to remove the primary disease and the presence of healthy tissue with which the fistula is closed. Ideally, healthy tissue with good blood supply is brought between the bladder and the other organ. The presence of unremovable cancer or tissue exposed to radiation and having a bad blood supply make a good result more difficult to obtain. The patient can expect to have a catheter in their bladder for a few weeks postoperatively. 

Reviewed July, 2003

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Glossary Terms

anatomy:
	The physical structure of an internal structure of an organism or any of its parts.
bladder:
	The bladder is a thick muscular balloon-shaped pouch in which urine is stored before being discharged through the urethra.
bowel:
	Another word for intestines or colon.
cancer:
	An abnormal growth that can invade nearby structures and spread to other parts of the body and may be a threat to life.
catheter:
	A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray.
colon:
	Large intestine.
diverticulitis:
	Inflammation of the diverticula along the wall of the colon.
enterovesical fistula:
	An abnormal opening or passage between the colon and bladder.
excretory urogram:
	Also known as intravenous pyelogram. A test that uses X-rays and contrast dye to take pictures of the kidneys, ureter and bladder.
fistula:
	An abnormal opening between two organs (between the bladder and vagina in women or the bladder and the rectum in men).
infection:
	A condition resulting from the presence of bacteria or other microorganisms.
inflammatory:
	Characterized or caused by swelling, redness, heat and/or pain produced in an area of the body as a result of irritation, injury or infection.
ions:
	Electrically charged atoms.
pathology:
	The process of a particular disease. Scientific study of the nature, origin, progress and cause of disease.
radiation:
	Also referred to as radiotherapy. X-rays or radioactive substances used in treatment of cancer.
radiation therapy:
	Also referred to as radiotherapy or radiation. X-rays or radioactive substances used in treatment of cancer.
radiologist:
	Doctor specializing in the interpretation of X-rays and other scanning techniques for the diagnosis of disorders.
tissue:
	Group of cells in an organism that are similar in form and function.
urethra:
	A tube that carries urine from the bladder to the outside of the body. In males, the urethra serves as the channel through which semen is ejaculated and it extends from the bladder to the tip of the penis. In females, the urethra is much shorter than in males.
urinary tract:
	The system that takes wastes from the blood and carries them out of the body in the form of urine. Passageway from the kidneys to the ureters, bladder and urethra.
urinary tract infection:
	Also referred to as UTI. An illness caused by harmful bacteria, viruses or yeast growing in the urinary tract.
vagina:
	The tube in a woman's body that runs beside the urethra and connects the uterus (womb)to the outside of the body. Sometimes called the birth canal. Sexual intercourse, the outflow of blood during menstruation and the birth of a baby all take place through the vagina.
vas:
	Also referred to as vas deferens. The cordlike structure that carries sperm from the testicle to the urethra.

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