Endoscopic closure of a radiation induced colovesical fistula using the novel over-the-scope Padlock Clip system—a case report

Abstract

Colovesical fistulas (CVFs) are known complications of complicated diverticular disease, malignancy, and Crohn's colitis (1). With the increasing use of radiation therapy in relation to pelvic malignancies, we now have a rising incidence of benign radiation induced CVF that could potentially lead to recurrent bouts of cystitis, pyelonephritis, renal abscesses, renal impairment and systemic infection resulting from ongoing fecal contamination through the abnormal connection (2). The complications of urosepsis, in particular, carry high morbidity and mortality, and thus CVF should generally be an indication for surgical repair to avoid these problems (3). Unfortunately, not all patients are fit

Endoscopic Treatment Using the Padlock Clip System for Rectourethral Fistula After Prostatectomy

“…Velayos et al [ 6 ] treated a fistula in the sigmoid colon, but it was non-visible through colonoscopy and a consequence of an inflammatory-associated disease. Chiam et al [ 5 ] also used the same endoscopic device to close the radiation-induced colovesical fistula. Those examples confirm the uniqueness and relevance of the present case.…”

“…There currently needs to be an agreement on the best technique for repairing [ 4 ]. We can now explore the possibility of endoscopic closure for intestinal fistulas because of recent advancements in endoscopic procedures [ 5 ]. Over 40 approaches have been described in the literature, ranging from transanal endoscopic microsurgery to transabdominal surgery [ 4 ].…”