Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

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

    Article  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. 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.

  4. 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.

    PubMed  PubMed Central  Google Scholar 

  5. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 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.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Division of Female Urology, Pelvic Reconstructive Surgery & Voiding Dysfunction, University of California Irvine Health, 333 City West Blvd., suite 2100, Orange, CA, 92868, USA

    Mashrin Lira Chowdhury, Cristina Palmer & Gamal Ghoniem

  2. University of California Irvine School of Medicine, Orange, CA, USA

    Aricia Shen

Authors
  1. Mashrin Lira Chowdhury
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aricia Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cristina Palmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gamal Ghoniem
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gamal Ghoniem.

Ethics declarations

Conflicts of interest

Cogentix/Laborie participation: project development, manuscript writing.

Informed consent

No informed consent was required for this report per the University of California Irvine Institutional Review Board.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chowdhury, M.L., Shen, A., Palmer, C. et al. Workup and conservative management of ileal conduit-vaginal fistulas: review of literature. Int Urogynecol J 31, 1377–1379 (2020). https://doi.org/10.1007/s00192-019-04143-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-019-04143-0

Keywords

Search

Navigation