Man's Incontinence Traced to Rare Bladder-Bowel Fistula
A 40-year-old Taiwanese man's severe urinary incontinence was caused by a rare fistula connecting his bladder and colon, likely created when a colonoscopy ruptured his weakened bladder wall following diverticulitis. Minimally invasive surge
A Taiwanese physician has documented the case of a 40-year-old man with severe urinary incontinence who needed to change his underwear three times daily, each time with yellowish stains. Initially dismissing the condition as normal, he only sought medical attention when his worried wife insisted on a hospital visit, nearly sparking a domestic argument in the process.
When doctors reviewed his history, they discovered that four months earlier he had been hospitalized for two weeks with diverticulitis (inflamed colon pouches). About a month after recovery, he underwent a colonoscopy, and his incontinence symptoms began shortly thereafter. He attributed the loose anal sphincter sensation to the colonoscopy procedure, along with occasional abdominal pain and persistent low fever.
Urine tests revealed a bacterial infection with significant debris, prompting doctors to suspect an abnormal connection between his bladder and colon. Imaging confirmed that the inflamed colon segment had adhered to and gradually thinned the bladder wall. During the colonoscopy, air was introduced to expand the colon; this pressure likely ruptured the already-weakened bladder wall, creating a small fistula connecting the bladder and colon.
When urine accumulated and built pressure in the bladder, it would leak through the fistula into the colon and exit through the rectum, mimicking incontinence. The yellow stains were actually urine mixed with fecal matter. If left untreated, the condition could have required removal of parts of both the bladder and colon.
Fortunately, the wife's early vigilance allowed for prompt treatment. Surgeons used a minimally invasive endoscopic approach to separate the bladder from the colon and close the fistula, avoiding more extensive surgery. Had the infection worsened, he would have needed treatment from both urologists and colorectal surgeons, potentially requiring large sections of both organs to be removed.
This case underscores the importance of not ignoring recurring minor symptoms, especially changes in bowel or bladder function with abnormal discharge, as they may signal serious conditions requiring urgent medical attention.
