Diagnosis of Urinary Fistula

Diagnosis of urinary fistula

Depending on the patient's symptoms and medical history, the necessary diagnostic tests will be performed.

Computed tomography of the fistula:

This is a diagnostic imaging method that uses X-rays to create cross-sectional images of the body. It allows visualization of the presence of gas within the interior of the bladder, or the pathways of the fistula itself, when the exam is performed with contrast.

Radioscopy:

It is another diagnostic imaging technique that uses X-rays to obtain real-time images of the patient's internal structures. It allows the diagnosis of primary disease such as diverticulitis or Crohn's disease.

Contrast enema examination and colonoscopy:

They can help in the evaluation of tests for colon disease.

Cystoscopy:

This test can diagnose most cases. It involves examining the lining of the bladder and urethra (tube that carries urine out of the body) through a cystoscope, which is a hollow tube with a lens that is inserted through the urethra.

Biopsy:

Sometimes a biopsy is also done to see if there is any disease in the bowel, when cancer is suspected.

The Bourne test and the poppy seed test:

For this test, patients have to consume the poppy seeds and then have a urine test. If particles of the seeds are found in the urine, the test is positive and a fistula is diagnosed, although it does not tell where the fistula is nor does it evaluate the bowel wall.

While studying the poppy seed test, the physicians discovered that the test provides 100% diagnostic accuracy, making it the most accurate test available.

Oral administration of activated charcoal:

If a fistula is present, this substance will appear in the urine in the form of black particles. This test does not give any information where the fistula is, but it is useful to confirm the diagnosis in suspected cases.

Vital dyes:

Rectal administration of vital dye: this test has been recommended for the diagnosis of occult colovesical fistula. However, the dye can be absorbed and comes out in the urine even if there is no fistula.

Find out more about

Urinary Fistula

Symptoms and causes Treatment Outcomes and quality of life

They ask us

in the Consultation

How long does it take for a urinary fistula to heal? 

If the fistulas are not operated, the probability of spontaneous healing is low, although sometimes they can close with the placement of a bladder catheter. However, the time required is not short, requiring several weeks.

How can a urinary fistula be treated? 

Treatment ranges from conservative maneuvers such as bladder catheterization to the need for surgery. The type of surgery depends on the origin and size of the fistula and may require a vaginal, abdominal or laparoscopic approach. In cases of fistulas from the urinary tract to the digestive tract, a colostomy may be required, i.e. a bag to collect the feces.

What is the relationship between urinary fistulas and radiotherapy?

In case of radiotherapy, fistulas usually have a more complex treatment. Radiotherapy is an effective treatment in multiple tumors and its complications are rare. However, on isolated occasions, especially in association with pelvic surgery, it increases the risk of development of fistulas from the urinary tract to the vagina or the gastrointestinal tract.

I have been diagnosed with a urinary fistula, which specialist should treat me?

First of all, an evaluation by a urologist specializing in reconstructive urology should be performed. He or she will adequately evaluate the patient's condition in order to propose an individualized treatment.

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