Urological complications in chronic inflammatory diseases of the bowel

In advanced stages, the three most common inflammatory bowel diseases - colonic diverticulitis, Crohn's disease and ulcerative colitis - cause, in some 10% of cases, secondary urological pathology involving either bladder or ureter. Colovesical fistula is found more frequently in diverticulitis and less often in Crohn's disease, which penetrates predominantly from the ileum into the bladder. On the other hand, if uretic stenosis develops it will be caused on the right side by Crohn's disease and on the left by ulcerative colitis. Vesico-intestinal fistulae will close without sequelae after resection of the diseased bowel segment. On the other hand, retroperitoneal ureteric stenosis - despite bowel resection and ureterolysis - will often require nephrectomy if operation is not carried out early enough. Frequent re-checks with infusion excretory urography will help to prevent this. Nephrolithiasis, amyloidosis and contracted bladder are other, though less common, complications of chronic inflammatory diseases of the bowel.