Urosymphyseal fistula after pelvic radiotherapy in a tertial referral centre: a rare entity with significant comorbidity requiring multidisciplinary management

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Urosymphyseal fistula after pelvic radiotherapy in a tertial referral centre : a rare entity with significant comorbidity requiring multidisciplinary management

Brändstedt, Johan (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Abrahamsson, Johan (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urology - urothelial cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

Baseckas, Gediminas (författare): Department of Translational Medicine, Lund University, Lund, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden

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Bobjer, Johannes (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Gerdtsson, Axel (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Gunnlaugsson, Adalstein (författare): Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden

Kollberg, Petter (författare): Umeå University,Umeå universitet,Urologi och andrologi

Lydrup, Marie Louise (författare): Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

Nyberg, Martin (författare): Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urological cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

Wenger, Daniel (författare): Lund University,Lunds universitet,Ortopedi - klinisk och molekylär osteoporosforskning,Forskargrupper vid Lunds universitet,Orthopedics - Clinical and Molecular Osteoporosis Research,Lund University Research Groups,Skåne University Hospital

Sörenby, Anne (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Tham, Johan (författare): Lund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Clinical infection medicine,Lund University Research Groups,Skåne University Hospital

Warnolf, Åsa (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Liedberg, Fredrik (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urinblåsecancer,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Urology - urothelial cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Urothelial cancer,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

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Medical Journals Sweden AB, 2023
2023
Engelska.
Ingår i: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 58, s. 4-10

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Objective: To report population-based clinical presentation and outcomes in patients with urosymphyseal fistula (USF) after pelvic radiotherapy (RT).Patients and methods: A retrospective chart review was performed in 33 consecutive patients diagnosed with suspicion of USF in a tertial referral center from 2014–2022 to ascertain information about diagnostic delay, clinical presentation, precipitating causes, treatments received and outcomes during the median 22 months follow-up. Out of 33 consecutive patients with suspicion of USF, one female with vesicovaginal fistula, one patient developing RT-associated bladder angiosarcoma, four patients with short follow-up (<3 months), and three patients that during chart review not were considered to have a USF were excluded.Results: In all, 24 males with a median age of 77 years were diagnosed with USF. Local pain was the predominating symptom in 17/24 (71%) patients. Endourologic manipulations preceded the diagnosis of USF in 16 patients. Five patients had a diagnostic delay of more than 3 months. At diagnosis, 20/24 patients had radiological signs of osteomyelitis, and five had a concomitant rectourethral fistula. Due to comorbidity, five patients were not amenable to any other interventions than urinary catheter or suprapubic tube in conjunction with long-term antibiotics, of which three died from infections related to the USF. Out of the remaining 19 patients receiving some form of urinary diversion, five had recurrent osteomyelitis, of which four did not undergo cystectomy in conjunction with surgery for the USF.Conclusions: Urethral endourologic interventions in patients previously subjected to pelvic RT should be performed cautiously.

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Av författaren/redakt...: Brändstedt, Joha ...; Abrahamsson, Joh ...; Baseckas, Gedimi ...; Bobjer, Johannes; Gerdtsson, Axel; Gunnlaugsson, Ad ...; visa fler...; Kollberg, Petter; Lydrup, Marie Lo ...; Nyberg, Martin; Wenger, Daniel; Sörenby, Anne; Tham, Johan; Warnolf, Åsa; Liedberg, Fredri ...; visa färre...

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Urosymphyseal fistula after pelvic radiotherapy in a tertial referral centre : a rare entity with significant comorbidity requiring multidisciplinary management

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