Fistulas to the urinary system in Crohn's disease: clinical features and outcomes.

摘要: Abstract OBJECTIVES: Most reports of fistulas to the urinary system in Crohn’s disease are relatively small. We sought describe clinical features and outcomes these patients. METHODS: A centralized diagnostic index identified all patients with tract who were evaluated at our institution between 1976 2000. Medical records abstracted for patient demographics, presenting symptoms, tests, therapies. RESULTS: total 78 (56% men) identified. Patients presented pneumaturia (68%), dysuria (64%), recurrent infections (32%), fecaluria (28%). Cystoscopy CT abdomen/pelvis had highest yield (74% 52%, respectively). Fistulas originated from ileum colon (21%), rectum (8%), multiple sites (7%). Urinary included bladder (88%), urethra (6%), urachus (3%), ureter (1%), other (1%). Median follow-up was 1.1 yr (0–22.3 yr). 70 (90%) surgery, medical treatment first attempted four antibiotics and/or immunosuppressants. One adequate symptom relief without surgery on antibiotic suppression alone. Six required a partial cystectomy, but no cystectomy or nephrectomy. Only three surgical fistulas. CONCLUSIONS: occurred more often men. pneumaturia, dysuria, infections, fecaluria. The most helpful tests cystoscopy abdomen/pelvis. Surgery resulted durable remission. therapy deserves further study.