Review

Authors: M C McCullough, E E Oh, J A Lucci...

The authors intended to perform a comprehensive review of the literature pertaining to ureteroarterial fistulae and apply the findings to a case. A comprehensive literature search was performed using the Keywords: ureter, artery and fistula. The available articles printed in or translated to English were analysed for overall trends. The results were then compared with the case of a patient (index patient). Review of the literature reveals that 57% of all ureteroarterial fistulae form in women at an average age of 58. The most common presenting complaint is haematuria. There appears to be a shift in management from primarily open surgical to primarily angiographic. The known risk factors are: vascular pathology, malignancy, prior radiation and indwelling stents. While 98% of all cases have at least one known risk factor, only 41% had two or more. We report an additional case of this rare condition, and review the present literature.

Topics: Endometrial Neoplasms; Female; Hematuria; Humans; Iliac Artery; Middle Aged; Stents; Ureteral Diseases; Urinary Fistula; Uterine Cervical Neoplasms; Uterine Hemorrhage; Vascular Fistula

PubMed: 22943703
DOI: 10.3109/01443615.2012.690788

Authors: Brandy M Butler, Rony A Adam, Ayush Giri...

INTRODUCTION AND HYPOTHESIS

The association between hysterectomy type, laparoscopy use and vesicovaginal fistula (VVF) is currently unclear and would be useful to determine route of surgery and provide adequate patient counseling. The objective of this study was to evaluate the magnitude of association between the use of laparoscopic assistance, recognized intraoperative urinary tract injury and subsequent VVF repair and to quantify any differences in fistula repair and injury detection by hysterectomy type. Lastly, we sought to determine whether the type of hysterectomy is a risk factor for VVF repair independent of injury identification.

METHODS

We performed a retrospective cohort study utilizing the Healthcare Cost and Utilization Project database examining benign hysterectomies performed in California, New York and Florida from 2005-2011. Multivariable logistic regression models were used to evaluate associations among hysterectomy type, reported injury and VVF.

RESULTS

Of 581,395 eligible hysterectomies, urinary tract injuries occurred in 6702 patients (1.15%) and 640 patients developed VVF (0.11%). Patients with reported injury were 20-fold more likely to develop VVF than those without (OR = 20.6; 1.96% vs. 0.089% respectively). The association between reported injury and VVF development was stronger if laparoscopy was involved (OR = 30) than if it was not (OR = 17). Patients undergoing laparoscopic procedures were less likely to have injury reported (OR = 0.6) but more likely to undergo VVF repair (OR = 1.5). This association with VVF repair was independent of injury identification. Patients developing VVF were more likely to have undergone total abdominal hysterectomy compared to other hysterectomy types.

CONCLUSIONS

Laparoscopy is an independent risk factor for the need for subsequent VVF repair, independent of hysterectomy type and presence of intraoperatively recognized urinary tract injury.

Topics: Female; Humans; Vesicovaginal Fistula; Retrospective Studies; Hysterectomy; Laparoscopy; Urinary Tract

PubMed: 36161347
DOI: 10.1007/s00192-022-05367-3

Authors: Abdallah Bensouda, Khalid El Hader, Leila Sbihi...

AIM

To present the results of the diagnostic and the management of entero-urinary fistulae.

METHODS

we performed a retrospective study on 18 patients with entero-urinary fistulas that had been diagnosed and treated at the Hospital Ibn Sina Rabat during the period spanning 1989-2006

RESULTS

The surgery was the main etiology of fistulas. The location was colo-vesical in 2 cases, prostato-rectal in 7 cases, vesico-rectal in 2 cases, uretero-colic in 3 cases, uretro-rectal in 3 cases and uretero-ileal in 1 case. The clinical manifestations were principally urological in the form of recurrent urinary infection, pneumaturia and fecaluria. The most useful diagnostic techniques were voiding retrograde cystourethrography and abdominal CT scan showing the fistulae in 12 cases. Treatment was by surgery in 15 cases. The transperitoneal way was adopted for the upper tract fistulas and the way of York Mason preferred for the lower urinary tract fistulas. No complications have been reported in the follow-up of these patients.

CONCLUSION

Although the diagnosis of entero-urinary fistulae seems easy, the management remains difficult. It depends on its location and on the general state of the patient. He must be appropriate to avoid a recurrence which the management would be more complicated.

Topics: Adolescent; Adult; Aged; Female; Humans; Intestinal Fistula; Male; Middle Aged; Retrospective Studies; Urinary Fistula; Young Adult

PubMed: 21049411
DOI: No ID Found

Review

Authors: Gerusa Dreyer, Denise Mattos, Joaquim Norões...

The rupture or fistulization of lymph vessels into the urinary system, known as chyluria (milky urine), is caused mainly by bancroftian filariasis. On rare occasions chyluria may also be caused by neoplasia, lymphatic malformation, abdominal trauma, as well as other infectious diseases such as tuberculosis. The authors proposed general guidelines to manage patients suffering from milky urine in Bancroftian filariasis endemic and non-endemic areas. They emphasized the importance of a careful diagnostic process accomplished using screening procedures, evaluating a detailed history of illness and performing a careful physical examination, targeting on the most suitable diagnostic tools for each case. In addition, they emphasized the need to manage the patient from a broader perspective, which goes beyond the medical aspect, involving also social and nutritional contexts. In the great majority of cases, controlling chyluria is fundamentally based on patient education and adjustment to a low lipid, high protein diet in addition to increased fluid intake.

Topics: Animals; Chyle; Diagnosis, Differential; Diet; Humans; Urinary Fistula; Urine; Wuchereria bancrofti

PubMed: 17952358
DOI: 10.1590/s0104-42302007000500025

Review

Authors: Kate H Kraft, Aseem R Shukla, Douglas A Canning...

Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications.

Topics: Diverticulum; Humans; Hypospadias; Male; Penis; Postoperative Complications; Plastic Surgery Procedures; Urethral Diseases; Urethral Stricture; Urinary Fistula

PubMed: 21516286
DOI: 10.1100/tsw.2011.76

Authors: Hubert Swana

Topics: Humans; Rectal Fistula; Urethral Diseases; Urinary Fistula

PubMed: 28124547
DOI: 10.1590/S1677-5538.IBJU.2015.0676.1

Authors: N Szabla, A Alves, X Tillou...

Topics: Colonic Diseases; Humans; Intestinal Fistula; Kidney Diseases; Kidney Transplantation; Middle Aged; Pyelonephritis; Tomography, X-Ray Computed; Transplant Recipients; Urinary Fistula

PubMed: 31101547
DOI: 10.1016/j.jviscsurg.2019.04.009

Authors: Mohammed Alae Touzani, Othmane Yddoussalah

Urethral duplications are extremely rare congenital malformations. The most used classification is that of Effmann and Lebowitz, describing 6 types of urethral duplications. The under type IIA2-Y is one of the most rare duplications corresponding to duplicated urethra originating from the bladder neck and extending toward the ectopic perineal or anal insertion. We here report the case of a 32 year patient, with no previous personal history, suffering from urinary leakage during and after urination since childhood. Clinical examination showed a bottleneck at the level to the perineum initially suggesting urethral fistula. However, the absence of fistula-associated urinary disorders as well as urinary leakage since childhood refuted this assumption. The patient underwent Micturating Retrograde Urethrocistography after perineal orifice catheterization confirming well systematized tract. Surgical exploration was based on excision of the duplicate urethra after hydrophilic catheterization by inserting hydrophilic guidewire up to its anastomosis at the level of the prostate. The examination of the surgical specimen confirmed the diagnosis of supernumerary urethra.

Topics: Adult; Humans; Male; Urethra; Urethral Diseases; Urinary Fistula; Urologic Surgical Procedures, Male

PubMed: 29187923
DOI: 10.11604/pamj.2017.27.254.12065

Authors: J Andrade Sabogal, I García Moreno, C Blanco González...

INTRODUCTION

Colorenal fistula is rare in the pediatric population. It may occur at any segment involved by ischemia, chronic inflammation, or necrosis. It is typically associated with a preliminary renal lesion that may arise as a result of interventional procedures, inflammatory conditions, colon tumor, and xanthogranulomatous pyelonephritis, among others.

CASE REPORT

15-year-old female patient diagnosed with acute lymphoblastic leukemia admitted at our institution for baseline condition management. During her stay, she experienced gastrointestinal and urinary infectious events. In the assessment and management of those, a left colorenal fistula was found. Surgical treatment was decided upon.

DISCUSSION

Colorenal fistula typically occurs secondary to renal inflammation or infection. Clinical signs are highly variable, and treatment is surgical, with the fistulous tract being resected in all cases.

Topics: Adolescent; Child; Female; Humans; Intestinal Fistula; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Pyelonephritis, Xanthogranulomatous; Urinary Fistula; Urinary Tract Infections

PubMed: 34606703
DOI: No ID Found

Authors: Jan Schinköthe, Kerstin Gerlach, Reiner G Ulrich...

A 12-y-old Shetland Pony was presented with a mucus-secreting fistula in the right paralumbar fossa. Surgery was performed to unravel the origin of the fistula. The horse died under anesthesia and was forwarded to autopsy. The right kidney was markedly atrophic and fibrotic, consistent with unilateral end-stage kidney. The right ureter was markedly thickened, but with luminal continuity leading into the urinary bladder where a partial obstruction caused by nodular para-ureteral fat necrosis was evident. The lumen of the cutaneous fistula was continuous with the right ureter; therefore, we diagnosed the lesion as a ureterocutaneous fistula. Anomalies of the ureter are uncommon, and ureterocutaneous fistula formation in equids has not been reported previously to our knowledge.

Topics: Horses; Animals; Ureter; Urinary Fistula; Kidney; Pyelonephritis; Cutaneous Fistula; Horse Diseases

PubMed: 37408505
DOI: 10.1177/10406387231186134