World Journal of
Pharmaceutical and Life Sciences

TREATMENT OF COLOVESICAL FISTULA DUE TO DIVERTICULAR DISEASE WITHOUT INTRAOPERATIVE BLADDER REPAIR OR POSTOPERATIVE CYSTOGRAPHY

*Dr. Allawi Muhi Jasim, Dr. Mohammed Abdullah Mohammed and Dr. Thaker Thiab Hmood

ABSTRACT

The treatment of colovesical fistula (CVF) due to diverticular disease is complex procedure and imposes significant risk to the patient. Specifically, management of the bladder defect after fistula takedown is inconstant. In this quality improvement study, we focus on the safety of early (< 7 days) urethral catheter removal without intraoperative or postoperative bladder imaging. This retrospective study was carried out at Falluja Teaching Hospital/Iraq during the period from 2005 and 2019 on 15 patients who were operated for CVF due to diverticular disease and underwent fistula takedown. Medical records were reviewed to obtain patient characteristics, operative technique and findings and postoperative outcomes. Bladder defects were only formally repaired if urothelium was visualized intraoperatively. Mean postoperative urethral catheterization was 5.7 days and bladder imaging was not performed intraoperatively or postoperatively. There were no urinary-related complications or mortalities, and mean follow-up was 200 ± 34.5 days. It can be concluded from this study that early removal of Foley catheter (< 7 days) after sigmoid resection for diverticular colovesical fistula is safe in select cases. Routine intraoperative primary bladder repair and postoperative bladder imaging is not required when the defect is small or when no gross hole with direct vision of the urothelium is found.

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