[Acquired enterovesical fistulas]

Area of Science:

• Urology
• Gastroenterology
• Surgical Oncology

Background:

• Acquired vesicoenteric fistula is a complex condition with diverse etiologies.
• Common symptoms include pneumaturia and fecaluria, significantly impacting patient quality of life.
• Diagnosis and management require a multidisciplinary approach.

Purpose of the Study:

• To review the etiology, diagnosis, and treatment of acquired vesicoenteric fistulae.
• To evaluate the effectiveness of diagnostic modalities and surgical interventions.
• To provide insights into optimal management strategies based on a 12-year experience.

Main Methods:

• Retrospective analysis of 23 patients with acquired vesicoenteric fistula treated over 12 years.
• Review of patient records, focusing on etiology, symptoms, diagnostic procedures, and treatment outcomes.
• Cystoscopy and various imaging techniques were employed for diagnosis and staging.

Main Results:

• Inflammatory (48%), neoplastic (35%), and iatrogenic (17%) causes were identified.
• Pneumaturia and fecaluria were the most frequent presenting symptoms (78%).
• Cystoscopy proved highly effective for fistula detection (13/18 cases); imaging aided in assessing GI status and etiology.

Conclusions:

• Acquired vesicoenteric fistulae necessitate tailored treatment based on etiology, location, and patient condition.
• Surgical resection of the fistulous tract and involved intestinal segment, coupled with bladder suture, is a frequently applied and effective treatment.
• Accurate diagnosis, often aided by cystoscopy, is crucial for successful management.