Ms. [Name] presented [Date] for evaluation of a left posterior bladder wall lesion consistent with either a tumor versus fistula tract. She had previously undergone CT IVP which demonstrated a diverticulosis of the sigmoid colon with air within the bladder. There was also apparent communication between the sigmoid colon and the bladder, although the CAT scan was non-contrast. This was suspicious for evidence of a colovesicular fistula. Previously the patient has denied history of pneumaturia, but had had recurrent urinary tract infections, as well as microhematuria.
We took her to the operating room, and performed bilateral retrograde pyelograms which we normal. The images are in her office chart. Additionally we performed a cystogram on the table, and filled her bladder with _____(greater) of 300 mL of Cysto-Conray. Images were taken with both a full and empty bladder. We put patient in a left oblique position. There was no evidence of fistula tract at this time. …show more content…
We are unable to find any areas of tumor or a discernible fistula tract at the time of inpatient cystoscopy. A biopsy was taken of the left posterior bladder wall where there was evidence of cystitis cystica, and a mild amount of erythema. This possibly represents the field fistula