[Diagnosis and treatment of vesico-intestinal fistula]

In a retrospective study of 28 patients with vesico-intestinal fistula, the maximal diagnostic latency was eight years. The most common causes were diverticulitis (16 patients) and carcinoma of the colon (4 patients). Recurrent urinary tract infections with pneumaturia and/or faecaluria were found in 23 patients. The diagnosis was most accurately confirmed by cystoscopy and barium enema which showed evidence of a fistula in 20 patients. Patients suffering from diverticulitis were managed with excellent results while surgical intervention in malignancy was associated with brief survival. Diverting colostomy as a sole procedure in patients with infravesical obstruction involves the risk of rectal miction.