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Urologic aspects of vesicoenteric fistulas
The Journal of Urology
|June 1, 1978
Summary
Vesicoenteric fistulas often lack classic symptoms, presenting instead with fever or cystitis. Early diagnosis via cystoscopy and prompt surgical repair significantly improve patient outcomes.
Area of Science:
- Urology
- Gastroenterology
- Surgical Oncology
Background:
- Vesicoenteric fistulas are abnormal connections between the bladder and the gastrointestinal tract.
- Classic symptoms like pneumaturia and fecaluria are not always present, complicating diagnosis.
Purpose of the Study:
- To analyze the clinical presentation, diagnostic methods, etiologic factors, and treatment outcomes for patients with vesicoenteric fistulas.
Main Methods:
- Retrospective review of 100 patients diagnosed with vesicoenteric fistulas.
- Analysis of presenting symptoms, diagnostic techniques (cystoscopy, roentgenography), etiology, and treatment strategies.
Main Results:
- Fever, abdominal mass, or cystitis were common presenting symptoms, while pneumaturia/fecaluria were infrequent.
- Urinary tract infection occurred in 95% of patients; cystoscopy was the most effective diagnostic tool (79%).
- Inflammatory bowel disease (63%) and colorectal adenocarcinoma (16%) were primary causes.
Conclusions:
- Vesicoenteric fistulas present with varied symptoms, necessitating a high index of suspicion.
- Cystoscopy is crucial for diagnosis, and surgical repair offers favorable outcomes for operable patients.