Before I get to the question, there's a background story. In Aug. 2013 I had a big ileocaecal resection. It went well and healed well, no dramas. In the June, with CRP over 100, I'd been admitted to hospital after a colonography showed a big mass in the ileal small bowel. I had full workups, including gynae, because I was having slight vaginal bleeding and I was 66. Included in that was a pelvic ultrasound. The bladder wasn't in the picture because, after the prep drinks, I'd been kept waiting in radiology for 4 hours while they were dealing with a lass who was in the throes of a miscarriage. Eventually, I simply HAD to pee and there were no facilities to get a drink of water to replenish. (An empty bladder doesn't show up on ultrasound.) Anyway, the gynae results were A1 - "marvellous for your age", etc.
Fast forward to December 2013, when I started having severe pain passing water and my pee was coming out frothy. Dr gave me an antibiotic for UTI that didn't clear it up. Shortly after, I began breaking wind from the front passage. Literally, as I walked, it would be going "pop!pop!pop!". As I had two diverticulae in the sigmoid bend, that I'd seen with my own eyes during a colonoscopy the year before, I suspected I had a fistula from one of those through to the bladder.
I first raised it with my GE doctor the next month (Jan. 2014). His comment was "I'm not a gynaecologist". Nor did he refer me to one, nor to a urologist. CRP at that stage was in the high 20s, which he thought was OK. I put myself on 80K units of cranberry tabs. Nothing improved and, by the end of April, the urine was brown and smelt of poo.
Meanwhile, I'd developed a partial blockage, with chronic constipation and my small and large bowels were so dilated I looked 10 mths pregnant. Saw the GE dr again in June; he ordered a CT scan in July; in Aug., having been unable to keep food or water down for 2 weeks or pass a BM for a month, and refluxing faecal matter, with CRP in high 70s, I was admitted for another CT scan, followed by emergency surgery to get rid of the diverticulae, which had fused together across the bowel and blocked it totally. I was pretty lucky, as the surgeon took just the sigmoid bend and I lost only about 30cm of colon. I woke up with a colostomy. When the surgeon visited, I asked him about the bladder. He said there was no involvement with the sigmoid.
It took a lot longer to get past this surgery than the previous one. I came home without relief from the urinary tract problem. Six months later, my condition is better than I can remember. I'm still getting UTIs and peeing froth, although the urine is a good colour and not smelly. Because I still have the rectum and anus intact, I pass wind and mucous from there from day to day, especially if the stoma is having a particularly busy time. When I do, I also do the "front farting" and get an urgent need to urinate. I'm not incontinent, but I do have to heave hard on the pelvic floor to make it in time.
My GP did a speculum exam recently while she was doing my regular smear test. (All clear, that.) She noticed that the uterus was prolapsing slightly. Given the clean bill I had 18mths ago at the gynae workup, this is new. I think I probably caused that with all those months of straining to pass BMs last year. Darn! She has given me Ovestin cream which she thinks might help the prolapse.
Now, the question that all this was leading up to: How on Earth can I get UTIs when I have a colostomy?
Fast forward to December 2013, when I started having severe pain passing water and my pee was coming out frothy. Dr gave me an antibiotic for UTI that didn't clear it up. Shortly after, I began breaking wind from the front passage. Literally, as I walked, it would be going "pop!pop!pop!". As I had two diverticulae in the sigmoid bend, that I'd seen with my own eyes during a colonoscopy the year before, I suspected I had a fistula from one of those through to the bladder.
I first raised it with my GE doctor the next month (Jan. 2014). His comment was "I'm not a gynaecologist". Nor did he refer me to one, nor to a urologist. CRP at that stage was in the high 20s, which he thought was OK. I put myself on 80K units of cranberry tabs. Nothing improved and, by the end of April, the urine was brown and smelt of poo.
Meanwhile, I'd developed a partial blockage, with chronic constipation and my small and large bowels were so dilated I looked 10 mths pregnant. Saw the GE dr again in June; he ordered a CT scan in July; in Aug., having been unable to keep food or water down for 2 weeks or pass a BM for a month, and refluxing faecal matter, with CRP in high 70s, I was admitted for another CT scan, followed by emergency surgery to get rid of the diverticulae, which had fused together across the bowel and blocked it totally. I was pretty lucky, as the surgeon took just the sigmoid bend and I lost only about 30cm of colon. I woke up with a colostomy. When the surgeon visited, I asked him about the bladder. He said there was no involvement with the sigmoid.
It took a lot longer to get past this surgery than the previous one. I came home without relief from the urinary tract problem. Six months later, my condition is better than I can remember. I'm still getting UTIs and peeing froth, although the urine is a good colour and not smelly. Because I still have the rectum and anus intact, I pass wind and mucous from there from day to day, especially if the stoma is having a particularly busy time. When I do, I also do the "front farting" and get an urgent need to urinate. I'm not incontinent, but I do have to heave hard on the pelvic floor to make it in time.
My GP did a speculum exam recently while she was doing my regular smear test. (All clear, that.) She noticed that the uterus was prolapsing slightly. Given the clean bill I had 18mths ago at the gynae workup, this is new. I think I probably caused that with all those months of straining to pass BMs last year. Darn! She has given me Ovestin cream which she thinks might help the prolapse.
Now, the question that all this was leading up to: How on Earth can I get UTIs when I have a colostomy?
and ruling out the sigmoid colon means they have left the ileum untouched as a source for a fistula. E. Coli rules in a perianal source or an internal source - fistula. 
