Abstract
An 86-year-old woman, who had had a rupture of a neurogenic bladder at the age of 85, complained of pneumaturia with feces. She had been treated with an indwelling Foley's balloon catheter after the surgical treatment for neurogenic bladder in our hospital. A contrast medium enema examination showed the catheter to have penetrated from the bladder to the sigmoid colon. Computed tomography also revealed the tip of the catheter in the colon. Vesicocolic fistula caused by the Foley's balloon catheter was diagnosed, and surgical treatment was performed. At laparotomy, a vesicocolic fistula and penetration of the catheter to the sigmoid colon were identified. Closure by suture of the bladder wall, partial resection of the sigmoid colon, and external vesicostomy in the anterior wall were performed. Postoperative course was uneventful.
Vesicoenteric fistulae caused by the indwelling Foley's balloon catheter are rare. Only three cases have been reported in Japan. In case of vesicoenteric fistula caused by the Foley's balloon catheter, the best treatment would be removal of the catheter and closure of the fistula. In the present case, as it was difficult to remove the Foley's balloon catheter perennially for neurogenic bladder, we created an external vesicostomy. Intermittent withdrawing of urine can be selected as another treatment. Clinicians should note that long-term indwelling of a Foley's balloon catheter could cause a vesicocolic fistula.
