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Ausgedehnte bulbäre Harnröhrenfistel bei Morbus Crohn

Fallbericht einer erfolgreichen konservativen Therapie

Urethral fistula due to Crohn’s disease

Case report of successful conservative management

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Zusammenfassung

Wir berichten von einem Fall einer Harnröhrenfistelung bei Morbus Crohn. Unter konservativer Therapie mit Zystostomie, Metronidazol und Azathioprin kam es in unserem Fall zu einer vollständigen Abheilung der ausgedehnten paraurethralen Fistel. Rektourethrale Fistelungen sind äußert selten. Die typischen klinischen Symptome sind Pneumaturie, Fäkalurie, rezidivierende Harnweginfekte, Dysurie und eitriger Harnröhrenausfluss. Nach umfassender Diagnostik gewinnt die immunsuppressive Therapie in der Behandlung der Komplikationen des Morbus Crohn zunehmend an Bedeutung. Eine weiterführende Dauertherapie und Nachsorge des Patienten sind empfehlenswert.

Abstract

We report a case of a recto-urethral fistula in Crohn’s disease. In our case, suprapubic cystostomy, ciprofloxacin, metronidazole, and azathioprine led to complete remission. Recto-urethral fistulas due to Crohn’s disease are very uncommon. Pneumaturia, faecaluria, urinary tract infection, dysuria, and urethral discharge are the most common complaints. After complete diagnostics, immunosuppressive therapy in complicated Crohn’s disease is of increasing importance. It is recommended to continue treatment after healing to prevent further complications.

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Authors and Affiliations

  1. Klinik für Urologie, Kantonsspital, Rorschacher Straße 95, CH-9007, St. Gallen, Schweiz

    C. Schwab, D. Meyer, H.-P. Schmid & D.S. Engeler

  2. Klinik für Chirurgie, Kantonsspital, St. Gallen, Schweiz

    F.H. Hetzer

  3. Fachbereich Gastroenterologie, Departement Innere Medizin, Kantonsspital, St. Gallen, Schweiz

    J. Borovicka

Authors
  1. C. Schwab
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  2. D. Meyer
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  3. F.H. Hetzer
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  4. J. Borovicka
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  5. H.-P. Schmid
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  6. D.S. Engeler
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Corresponding author

Correspondence to C. Schwab.

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Schwab, C., Meyer, D., Hetzer, F. et al. Ausgedehnte bulbäre Harnröhrenfistel bei Morbus Crohn. Urologe 47, 1350–1352 (2008). https://doi.org/10.1007/s00120-008-1765-7

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  • DOI: https://doi.org/10.1007/s00120-008-1765-7

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