A fistula is an atypical connection between two epithelial surface. We studied retrospectively four male patients with enterovesical fistulas treated in our departments between March 2016 - March 2017. These included colovesical, rectovesical and ileovesical fistulas. Patients presented with urinary symptoms (pneumaturia, faecaluria and recurrent urinary tract infections). One patient had received radiotherapy after rectal resection for rectal carcinoma. For another of the cases the fistula was being due to periprostatic abscess. The third patient was diagnosed with bladder carcinoma with rectal invasion. The fourth patient was with direct invasion of sigmoid cancer to the bladder. The most common investigations included abdominal ultrasound, CT scan, cystoscopy and colonoscopy. Enteral stoma was performed in all cases as a part of surgical treatment.
All patients underwent open procedure, as a main rule enteral stoma was performed to cease the contamination, and primary repair of the bladder was performed. No recurrences were recorded, but there were several complications, including Clavien-Dindo gr. V. Most of the complications were treated by interventional urology. In conlusion, enteral division and primary repair of the bladder are safe approaches for treatment of enterovesical fistulas. As a rule ceasing of contamination should always be performed. Cystoscopy can manage most of the complications occurring in the early postoperative period. Scr Sci Med 2017; 49(3): 53-56
Mileski WJ, Joehl RJ, Rege RV, Nahrwold DL. One-stage resection and anastomosis in the management of colovesical fistula. Am J Surg. 1987;153(1):75-9.
Pollard SG, Macfarlane R, Greatorex R, Everett WG, Hartfall WG. Colovesical fistula. Ann R Coll Surg Engl. 1987;69(4):163-5.
Daniels IR, Bekdash B, Scott HJ, Marks CG, Donaldson DR. Diagnostic lessons learnt from a series of enterovesical fistulae. Colorectal Dis. 2002;4(6):459-62.
Najjar SF, Jamal MK, Savas JF, Miller TA. The spectrum of colovesical fistula and diagnostic paradigm. Am J Surg. 2004;188(5):617-21.
Bahadursingh AM, Virgo KS, Kaminski DL, Longo WE. Spectrum of disease and outcome of complicated diverticular disease. Am J Surg. 2003;186(6):696-701.
Randall D, Tittle V, Wright G, Blanshard C. Crohn`s disease and enterovesical fistulae: common things are common. Br J Hosp Med (Lond). 2010;71(9):530-1.
Gatta G, Di Grezia G, Di Mizio V, Landolfi C, Mansi L, De Sio I, et al. Crohn`s disease imaging: a review. Gastroenterol Res Pract. 2012;2012:816920. doi: 10.1155/2012/816920.
Gerber GS, Schoenberg HW. Female urinary tract fistulas. J Urol. 1993;149(2):229-36.
McBeath RB, Schiff M Jr, Allen V, Bottaccini MR, Miller JI, Ehreth JT. A 12-year experience with enterovesical fistulas. Urology. 1994;44(5):661-5.
Tonolini M, Bianco R. Multidetector CT cystography for imaging colovesical fistulas and iatrogenic bladder leaks. Insights Imaging. 2012;3(2):181-7. doi: 10.1007/s13244-011-0145-9.
Melchior S, Cudovic D, Jones J, Thomas C, Gillitzer R, Thüroff J. Diagnosis and surgical management of colovesical fistulas due to sigmoid diverticulitis. J Urol. 2009;182(3):978-82. doi: 10.1016/j. juro.2009.05.022.
Vidal Sans J, Pradell Teigell J, Palou Redorta J, Villagrasa Serrano M, Banús Gassol JM. Review of 31 vesicointestinal fistulas: diagnosis and management. Eur Urol. 1986;12(1):21-7.
Yamamoto T, Keighley MR. Enterovesical fistulas complicating Crohn`s disease: clinicopathological features and management. Int J Colorectal Dis. 2000;15(4):211-5; discussion 216-7.
Amin M, Nallinger R, Polk HC Jr. Conservative treatment of selected patients with colovesical fistula due to diverticulitis. Surg Gynecol Obstet. 1984;159(5):442-4.
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