Top

Published in:

01-07-2020 | Nephrostomy | Original Article

Workup and conservative management of ileal conduit-vaginal fistulas: review of literature

Authors: Mashrin Lira Chowdhury, Aricia Shen, Cristina Palmer, Gamal Ghoniem

Published in: International Urogynecology Journal | Issue 7/2020

Abstract

Ileal conduit-vaginal fistulas are a rare but challenging complication of urinary diversion. Here we identify risk factors and summarize the workup and conservative management strategies for this complication. We present two cases of elderly women with remote history of cancer who presented with persistent urinary leakage from the vagina several years after ileal conduit creation. Fistulas may be identified using dye or imaging with a loopogram and looposcopy. Correction of obstruction such as stomal stenosis or urinary diversion should be pursued to relieve pressure off the conduit. Minimally invasive management such as fulguration can result temporary relief; however, the recurrence rate is high.

Madersbacher S, Schmidt J, Eberle JM, et al. Long-term outcome of ileal conduit diversion. J Urol. 2003;169(3):985–90.CrossRef

Gilbert SM, Lai J, Saigal CS, et al. Downstream complications following urinary diversion. J Urol. 2013;190(3):916–22. https://doi.org/10.1016/j.juro.2013.03.026.CrossRefPubMed

Smith ZL, Johnson SC, Golan S, et al. Fistulous complications following radical cystectomy for bladder Cancer: analysis of a large modern cohort. J Urol 2017.

Kerr LA. Bulking agents in the treatment of stress urinary incontinence: history, outcomes, patient populations, and reimbursement profile. Rev Urol. 2005;7(Suppl 1):S3–S11.PubMedPubMedCentral

Sukha A, Smyth N. Fistula formation between the external iliac artery and ileal conduit following a radical cystoprostatectomy: a rare complication with prewarning signs of haemorrhage. BMJ Case Rep. 2015;2015:bcr2014208914. https://doi.org/10.1136/bcr-2014-208914.CrossRefPubMedPubMedCentral

Rosenberg S, Miranda G, Ginsberg DA. Neobladder-vaginal fistula: the University of Southern California experience. Neurourol Urodyn. 2018;37(4):1380–5. https://doi.org/10.1002/nau.23454.CrossRefPubMed

Falconi M, Pederzoli P. The relevance of gastrointestinal fistulae in clinical practice: a review. Gut. 2001;49(Suppl 4):iv2–iv10. https://doi.org/10.1136/gut.49.suppl_4.iv2.CrossRefPubMedPubMedCentral

Prcic A, Begic E. Complications after ileal urinary derivations. Med Arch. 2017;71(5):320–4. https://doi.org/10.5455/medarh.2017.71.320-324.CrossRefPubMedPubMedCentral

Stovsky MD, Ignatoff JM, Blum MD, Nanninga JB, O'Conor VJ, Kursh ED. Use of electrocoagulation in the treatment of vesicovaginal fistulas. J Urol. 1994;152(5 Pt 1):1443–4.CrossRef

10.

Carmel ME, Goldman HB, Moore CK, et al. Transvaginal neobladder vaginal fistula repair after radical cystectomy with orthotopic urinary diversion in women. Neurourol Urodyn. 2016;35(1):90–4. https://doi.org/10.1002/nau.22687.CrossRefPubMed

Title: Workup and conservative management of ileal conduit-vaginal fistulas: review of literature
Authors: Mashrin Lira Chowdhury
Aricia Shen
Cristina Palmer
Gamal Ghoniem
Publication date: 01-07-2020
Publisher: Springer International Publishing
Keywords: Nephrostomy
Cystectomy
Nephrostomy
Published in: International Urogynecology Journal / Issue 7/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-04143-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Workup and conservative management of ileal conduit-vaginal fistulas: review of literature

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 7/2020

Commentary on “The role of conventional pelvic floor reconstructive surgeries in obstructed defecation symptoms change: CARE and OPTIMAL trials sub-analysis of 2-year follow-up data”

Impact of postoperative instructions on physical activity following pelvic reconstructive surgery: a randomized controlled trial

The use of tomographic ultrasound imaging on three-dimensional translabial ultrasound: a diagnostic sign for urethral diverticulum

Laparoscopic repair of female genitourinary fistulae: 10-year single-center experience

Lipoleimyoma masquerading as uterine prolapse

Cost-effectiveness of a preoperative pelvic MRI in pelvic organ prolapse surgery