Colovesical Fistula due to Sigmoid Diverticulitis

Area of Science:

• Gastroenterology
• Urology

Background:

• Colonic diverticulosis incidence is rising, with diverticular disease frequently causing colovesical fistulas.
• Colovesical fistulas are rare complications of diverticulitis, often presenting with symptoms like fecaluria and pneumaturia.

Observation:

• A 43-year-old male presented with a six-month history of recurrent urinary tract infections.
• CT imaging confirmed a colovesical fistula, leading to surgical intervention.
• Surgical repair involved sigmoidectomy and colorectal anastomosis; the fistula tract itself was not visualized.

Findings:

• Surgical management of a colovesical fistula was successfully performed in a patient with persistent UTIs.
• The patient recovered well post-surgery, with catheter removal on day 10.

Implications:

• Persistent urinary tract infections warrant suspicion for colovesical fistulas, particularly when unresponsive to standard treatments.
• Specific symptoms like fecaluria and pneumaturia may not always require further imaging like barium enema or cystography for diagnosis.