[Urologic complications od chronic inflammatory intestinal diseases]

Area of Science:

• Gastroenterology and Urology
• Inflammatory Bowel Disease (IBD) Pathophysiology
• Genitourinary Complications of IBD

Context:

• Common inflammatory bowel diseases (IBD) include colonic diverticulitis, regional enteritis, and ulcerative colitis.
• Approximately 10% of advanced IBD cases involve the bladder or ureter.
• Urinary tract involvement presents significant diagnostic and management challenges.

Purpose:

• To elucidate the mechanisms and prevalence of urinary tract involvement in common inflammatory bowel diseases.
• To differentiate the patterns of vesicointestinal fistula and ureteric stenosis associated with specific IBD types.
• To highlight the importance of timely intervention in preventing severe urological sequelae.

Summary:

• Colovesical fistulas are more common with diverticulitis, while regional enteritis predominantly affects the ileum.
• Ureteric stenosis is primarily associated with regional enteritis on the right and ulcerative colitis on the left.
• Vesicointestinal fistulas often resolve post-bowel resection, but ureteric stenosis may necessitate nephrectomy if not treated promptly.
• Infusion urography is recommended for frequent monitoring to prevent complications.
• Less common complications include nephrolithiasis, amyloidosis, and contracted bladder.

Impact:

• Emphasizes the need for integrated care between gastroenterologists and urologists for IBD patients.
• Underscores the potential for severe, irreversible kidney damage if urinary complications are neglected.
• Promotes early diagnostic surveillance and proactive management strategies to improve patient outcomes and preserve renal function.