Fistulas between lower urinary tract and bowel: our experience in 15 years

Fistulas between bowel and low urinary tract are not frequent and could be due to different causes. Diagnosis and treatment need a particular care to assure to patient a good result. Authors report their last 15-years experience.

From 1990 and 2005 22 patients have been quite carefully investigated and surgically treated; 17 men and 5 women of age between 39 and 81 years old. In particular 2 vesico-ileal fistulas, 12 colo-vesical have been treated: in all these situations we proceed by intestinal resection and fistulas repairing at the same time. Three rectovesical and 3 recto-urethral fistulas have been treated by fistula's way removal (with different approaches) and in a case by preparing a definitive urinary derivation. Finally, 2 complex fistulas have been treated by preparing a definitive urinary derivation.

The typical symptoms presence must be carefully researched because it could be useful in diagnosis; radiological and endoscopic procedures could be useful for treatment planning, also if they have a quite low sensibility. In 20 cases, the treatment has achieved a good and lasting result. In 1 case we had a relapse, in another one patient died for sepsis.

Diagnosis of fistulas has to be quite careful and it is necessary to plan the treatment, that is always surgical, also considering that sometimes it's leading to serious complications.