A study of colovesical fistulae in a district hospital

A retrospective study of 32 patients with colovesical fistula was carried out. The most frequent presenting symptoms were urinary; an abdominal mass was found in 40% of patients. Urine culture grew bowel organisms in 93% of patients and the diagnosis was most accurately confirmed by barium enema which showed evidence of a fistula in 55% of patients examined. Surgical treatment varied from staged resection to primary resection and anastomosis, disconnection of the fistulous tract or colostomy alone. The results are compared and suggest a higher success rate with a multi-staged procedure. Different methods of diagnosis are discussed as well as possible causes for varying success rates among the surgical procedures.