title: Long-term antibiotic therapy in late onset pouch-urethral fistula after ileoanal anastomosis for ulcerative colitis may be effective and well tolerated.
abstract: A 25-year-old male patient underwent restorative proctocolectomy and ileoanal anastomosis in 1991 for refractory ulcerative colitis. In February 2001, he presented with pneumaturia, faecaluria, pelvic 'pressure' and watery diarrhoea caused by passage of urine through the anal canal. A fistula between the pouch and the membranous urethra was demonstrated by a pouchogram contrast study. In October 2002, he was started on ciprofloxacin 250 mg once daily and metronidazole 400 mg twice daily. Apart from a short break in 2003 the patient has remained on this regimen until the time of writing (now over 10 years) and has had sustained remission, excellent quality of life and no adverse effects.
authors.affiliation: Post Graduate Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Mario
authors.initials: M
authors.lastname: Samaha
authors.forename: Manus
authors.initials: M
authors.lastname: Moloney
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects*; D005402:Fistula / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D012074:Remission Induction; D013997:Time Factors; D014522:Urethral Diseases / Q000188:drug therapy* / Q000209:etiology*; D014548:Urinary Fistula / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole; D002939:Ciprofloxacin