RT Journal Article
T1 Outcomes of Medical and Surgical Therapy for Entero-urinary Fistulas in Crohn's Disease.
A1 Taxonera, Carlos
A1 Barreiro-de-Acosta, Manuel
A1 Bastida, Guillermo
A1 Martinez-Gonzalez, Javier
A1 Merino, Olga
A1 Garcia-Sanchez, Valle
A1 Gisbert, Javier P
A1 Marín-Jimenez, Ignacio
A1 Lopez-Serrano, Pilar
A1 Gomez-Garcia, Maria
A1 Iglesias, Eva
A1 Lopez-Sanroman, Antonio
A1 Chaparro, Maria
A1 Saro, Cristina
A1 Bermejo, Fernando
A1 Perez-Carazo, Leticia
A1 Plaza, Rocio
A1 Olivares, David
A1 Alba, Cristina
A1 Mendoza, Juan L
A1 Fernandez-Blanco, Ignacio
K1 Crohn’s disease
K1 Adalimumab
K1 Anti-TNF
K1 Entero-urinary fistula
K1 Enterovesical fistula
K1 Infliximab
AB The aims of this study were to evaluate the frequency of entero-urinary fistulas in a cohort of Crohn's disease (CD) patients and to analyse the outcomes of medical and surgical therapy. This multicentre retrospective study included all CD patients with entero-urinary fistulas diagnosed by the presence of clinical symptoms and confirmed at surgery or by radiological or endoscopic techniques. We evaluated outcomes of medical and surgical therapy. We defined remission as absence of clinical symptoms with a radiological confirmation of fistula closure. Cox regression analysis was performed to evaluate factors predictive of achieving remission without need for surgery. Of 6081 CD patients screened, 97 had entero-urinary fistulas (frequency 1.6%). Seventy-five percent of fistulas occurred in men. After a median follow-up of 91 months, 96% of patients were in sustained remission. Thirty-three patients (35%) received anti-tumour necrosis factor (TNF) therapy. Of these, 45% achieved sustained remission (median follow-up 35 months) without needing surgery. More than 80% of patients required surgery, which induced remission (median follow-up 101 months) in 99% of them. Only the use of anti-TNF agents was associated with an increased rate of remission without need for surgery (hazard ratio 0.23, 95% confidence interval 0.12-0.44; p  In this large cohort of CD patients, the frequency of entero-urinary fistulas was lower than previously described. More than 80% of patients required surgery, and in all but one of them surgery induced sustained remission. In a selected subgroup of patients, anti-TNF may induce long-term fistula remission and radiographic closure, making it possible to avoid surgery.
PB Oxford University Press
YR 2016
FD 2016-01-19
LK http://hdl.handle.net/10668/9748
UL http://hdl.handle.net/10668/9748
LA en
NO Taxonera C, Barreiro-de-Acosta M, Bastida G, Martinez-Gonzalez J, Merino O, García-Sánchez V, et al. Outcomes of Medical and Surgical Therapy for Entero-urinary Fistulas in Crohn's Disease. J Crohns Colitis. 2016 Jun;10(6):657-62
DS RISalud
RD Apr 19, 2025