Symptoms of rectovesical fistula?

summary

Rectourethral fistula is often difficult to repair due to trauma, infection and multiple operations, and the recurrence rate is high. The key to successful repair is to have good exposure to dissect the fistula quickly and safely; Secondly, the old scar and inflammatory tissue around the fistula should be fully removed, and the rectal fistula should be trimmed into the wound edge with blood supply; Third, the tissue with blood supply should be embedded between rectum and urethra to prevent recurrence of fistula. Symptoms of rectovesical fistula? Let's talk about it.

Symptoms of rectovesical fistula?

(1) Vesico intestinal fistula: symptoms of bladder irritation, fecal leakage and urethral exhaust may appear, often accompanied by changes in stool habits caused by primary intestinal diseases. Physical examination can find signs of intestinal obstruction. If it is caused by inflammatory diseases, abdominal muscle tension can be found. The examination of urine samples often indicates that the patients are complicated with infection. Barium enema and sigmoid colonoscopy can show the existence of fistula. Generally, after barium enema, urine samples are taken for centrifugation and X-ray examination. If opaque barium is found, cystocolonic fistula can be diagnosed. Cystoscopy has very important diagnostic value and can help to locate the fistula. Obvious inflammatory changes of bladder wall can be seen under cystoscope. Perfusion of contrast media through fistula cannula is often helpful in the diagnosis.

(2) Vesicovaginal fistula: more common, often secondary to obstetrics, surgery or radiation therapy injury or cervical cancer, in the cystoscope through the fistula intubation can be directly connected with the vagina, vaginal radiography can often be very good to show ureterovaginal, vesicovaginal and rectovaginal fistula. In addition, transvaginal insertion of Foley catheter, filling the water sac, perfusion of appropriate amount of contrast agent can also help the diagnosis. In some cases, canceration occurred at the edge of the fistula. Persky (1980) reported 6 cases of vesicovaginal fistula in children, all of which were complications of surgical injury.

(3) Bladder accessory fistula: this rare bladder fistula can be diagnosed by vaginal examination and detected by cystoscopy.

matters needing attention

The success rate of surgical repair of bladder fistula caused by benign diseases or surgical trauma is very high. Because of tissue necrosis after radiotherapy, the prognosis is often poor. It is difficult to treat the fistula secondary to invasive cancer.