Outcomes of Medical and Surgical Therapy for Entero-urinary Fistulas in Crohn's Disease

Journal of Crohn's & Colitis
Carlos TaxoneraIgnacio Fernández-Blanco

Abstract

The aims of this study were to evaluate the frequency of entero-urinary fistulas in a cohort of Crohn's disease (CD) patients and to analyse the outcomes of medical and surgical therapy. This multicentre retrospective study included all CD patients with entero-urinary fistulas diagnosed by the presence of clinical symptoms and confirmed at surgery or by radiological or endoscopic techniques. We evaluated outcomes of medical and surgical therapy. We defined remission as absence of clinical symptoms with a radiological confirmation of fistula closure. Cox regression analysis was performed to evaluate factors predictive of achieving remission without need for surgery. Of 6081 CD patients screened, 97 had entero-urinary fistulas (frequency 1.6%). Seventy-five percent of fistulas occurred in men. After a median follow-up of 91 months, 96% of patients were in sustained remission. Thirty-three patients (35%) received anti-tumour necrosis factor (TNF) therapy. Of these, 45% achieved sustained remission (median follow-up 35 months) without needing surgery. More than 80% of patients required surgery, which induced remission (median follow-up 101 months) in 99% of them. Only the use of anti-TNF agents was associated with an increased rate...Continue Reading

References

Apr 1, 1990·Diseases of the Colon and Rectum·M J McNamaraR G Farmer
Aug 1, 1989·Journal of Clinical Gastroenterology·M L Margolin, B I Korelitz
Aug 1, 1989·Journal of Clinical Gastroenterology·S Gorcey, I Katzka
Jun 1, 1985·AJR. American Journal of Roentgenology·S M GoldmanS S Siegelman
Aug 1, 1985·Diseases of the Colon and Rectum·R E GlassI P Todd
Jun 1, 1984·American Journal of Surgery·A J GreensteinA H Aufses
May 30, 1998·Gastroenterology·H L WaldumJ R Idle
Sep 29, 2000·International Journal of Colorectal Disease·T Yamamoto, M R Keighley
Feb 15, 2002·Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology·Daisuke IshiiShiro Baba
Oct 3, 2002·The American Journal of Gastroenterology·Daniel H Present
Oct 3, 2002·The American Journal of Gastroenterology·Craig A SolemWilliam J Sandborn
Nov 19, 2003·Scandinavian Journal of Gastroenterology·X GaméP Rischmann
Feb 27, 2004·The New England Journal of Medicine·Bruce E SandsSander J van Deventer
Apr 2, 2004·The American Journal of Gastroenterology·Mansour A ParsiAaron Brzezinski
Apr 30, 2005·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·D KavanaghJ M P Hyland
Jan 27, 2007·Journal of Pediatric Gastroenterology and Nutrition·Jonathan E TeitelbaumFrederic Daum
Dec 3, 2010·Journal of Crohn's & Colitis·A DignassUNKNOWN European Crohn's and Colitis Organisation (ECCO)
Dec 3, 2010·Journal of Crohn's & Colitis·Gert Van AsscheUNKNOWN European Crohn's and Colitis Organisation (ECCO)
Dec 19, 2013·Gastroenterology Research and Practice·Tomasz GolabekPiotr Chlosta
Jan 25, 2014·Journal of Clinical Gastroenterology·Wei ZhangJieshou Li
Mar 29, 2014·International Surgery·Yann-Rong SuChao-Yuan Huang

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Citations

Jan 7, 2017·World Journal of Gastroenterology : WJG·Shaul YaariEran Israeli
Dec 7, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S R BrownUNKNOWN ACPGBI IBD Surgery Consensus Collaboration
Dec 12, 2020·Diseases of the Colon and Rectum·Adekemi O Egunsola, David M Schwartzberg
Nov 24, 2020·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Nadia Moreno SánchezEduardo Moreno-Osset
May 28, 2019·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Guillaume BouguenUNKNOWN GETAID (Groupe d'Etude Thérapeutique des Affections Inflammatoires Digestives)

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