Aa
fistula
Hi,
I hoping to get a second opinion.
For the last year I have been living with a fistula between my prostate and rectum. I have had several cystoscopies and a CT scan. They could not determine a reason for this fistula. In 1995 I underwent a TURP and a resection of the bladderneck to remove an obstruction at the bladderneck. In 1996 I was diagnosed as having a neurogenic bladder for which I have used intermittant catherization.
In March of 2008 I came down with a kidney infection and while in hospital for this I noticed that I was passing gass through the cathter and penis.
In April the cystoscopy confirmed that there was a fistula.
The current urologist now wants to place a supra pubic catheter to divert the urine flow away from the fistula. Should this not work, he wants to divert to rectum by means of a colostomy. Is a colostomy really needed? Won't it cause more problems? can they not just remove the bad sections and join them back up? Don't they do somthing simmilar in the case of a radical prostatectomy?
I look forwar to hear your opinion.
Ron
I hoping to get a second opinion.
For the last year I have been living with a fistula between my prostate and rectum. I have had several cystoscopies and a CT scan. They could not determine a reason for this fistula. In 1995 I underwent a TURP and a resection of the bladderneck to remove an obstruction at the bladderneck. In 1996 I was diagnosed as having a neurogenic bladder for which I have used intermittant catherization.
In March of 2008 I came down with a kidney infection and while in hospital for this I noticed that I was passing gass through the cathter and penis.
In April the cystoscopy confirmed that there was a fistula.
The current urologist now wants to place a supra pubic catheter to divert the urine flow away from the fistula. Should this not work, he wants to divert to rectum by means of a colostomy. Is a colostomy really needed? Won't it cause more problems? can they not just remove the bad sections and join them back up? Don't they do somthing simmilar in the case of a radical prostatectomy?
I look forwar to hear your opinion.
Ron
MEDICAL PROFESSIONAL
We have discussed this to some extent before. Direct intervention, though difficult and not without complications, would seem to be the most reliable way to treat your fistula. Some would recommend a temporary colostomy to divert the fecal stream and allow the fistula repair to heal solidly. A supra-pubic catheter is not unreasonable to drain the bladder and not have a foreign body lying on the repair. Note that theses diversions are done in conjunction with a fistula repair and are not done in the hopes that the fistula will close spontaneously.
S.A.Liroff, M.D.
S.A.Liroff, M.D.
MEDICAL PROFESSIONAL
Might get some other opinions from another reconstruction oriented urologist (hands on opinions are usually best)
S.A.Liroff, M.D.
S.A.Liroff, M.D.
Thank you for your opinion.
As far as I know the urologist will only place the supra pubic catheter for now. No other medical intervention will be used to close the fistula. He seems to be under the impression that it might close on it's own. After having had this for a year I'm not convinced that it will.
Eventually time will tell what needs to be done, hopefully sooner then later.
Thank you.
Sincerely,
Ron
As far as I know the urologist will only place the supra pubic catheter for now. No other medical intervention will be used to close the fistula. He seems to be under the impression that it might close on it's own. After having had this for a year I'm not convinced that it will.
Eventually time will tell what needs to be done, hopefully sooner then later.
Thank you.
Sincerely,
Ron
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