647273 tn?1292094741

Fistula repair?

Dr. J Singh,

I have had my review with the urologist on September 23. I don't remember too much as I had just been treated for a groin abscess and sepsis.
A reverse urethrogram and cystoscopy were performed and showed that the fistula was still there since March of 2008.
The urologist told me that the fistula is small and that surgery might not be neccessary. He has me returing in March of 2010 for another cystoscopy.
My concerns are as follows.
1. The risk of UTI kidney infections. This was how the fistula was discovered by myself during a stay in hospital for a kidney infection and pneumonia.

2. The embarrisment of not being able to control passing gas through the penis. When this takes place, at times small amounts of urine will be expelled as well.

3. What will be the long term result of leaving the fistula as it is? Would it not be easier to repair this fistula now at the age of 45 than waiting till I'm older? the fistula has not healed after almost 2 years and I think that it will not close on it's own.

4. Should this fistula be repaired? Leaving it poses the risk of continued infections. Between 1996 up to 2003 I used to end up with kidney infections and UTI about every 3 to 4 months. I don't want this to happen again.
In 1995 I had surgery, resection of the bladderneck and TURP. Could this have caused a weak area? in 1996 I was diagnosed as having a neurogenic bladder. I used intermittant catherization. The urologist believes that I created the fistual with catherization. Would this not return if the suprapubic catheter is removed and I go back to self catherization?
the fistula is located between the prostate and rectum.

Your insight is greatly appreciated.

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