[Vesico-sigmoidal fistulas of diverticular origin]

From 1984 to 1993, 11 patients (7 men and 4 women, mean aged 70 years) underwent surgical procedure for sigmoido-vesical fistula due to diverticulitis. Fecaluria and/or pneumaturia was present in 10 patients. The diagnosis of sigmoido-vesical fistula due to diverticulitis was confirmed by urologic and colonic investigations. All patients underwent surgical treatment. One patient underwent creation of a diverting colostomy alone because of a poor general status. Definitive surgical correction of the fistula with resection of the diverticular colon was attempted in the remaining 10 patients, including colo-rectal anastomosis. A temporary diverting colostomy was performed in 5 cases. There was no post operative death. One small wound infection occurred. All the diverting colostomies have been closed, meanly 2 months after the operation. Concerning long-term results, 3 patients died from an independant reason. All the other patients are alive and asymptomatic from the urologic as well as the digestive point of view. Based on these results, we advocate single stage repair, including correction of the fistula and resection of the diverticular colon with colo rectal anastomosis, in cases of good local and general conditions.