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A 12-year experience with enterovesical fistulas

R B McBeath1, M Schiff, V Allen

  • 1Department of Surgery, University of Arizona Health Sciences Center, Tucson.

Urology
|November 1, 1994
PubMed
Summary

Enterovesical fistulas are often caused by diverticular disease. One-stage surgical repair is safe for diverticular or granulomatous causes, while staged repairs are better for complex cases.

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Area of Science:

  • Urology
  • Gastroenterology
  • Surgical Oncology

Background:

  • Enterovesical fistulas represent abnormal connections between the bowel and bladder.
  • Etiologies are diverse, including diverticular disease, malignancy, inflammatory bowel disease, and radiation therapy.
  • Accurate diagnosis and effective treatment are crucial for patient outcomes.

Purpose of the Study:

  • To review institutional experience with enterovesical fistulas.
  • To identify optimal diagnostic modalities.
  • To determine the most effective treatment strategies.

Main Methods:

  • Retrospective review of 76 patients diagnosed and treated for enterovesical fistulas over 12 years.
  • Data analyzed included presenting symptoms, underlying disease, diagnostic studies, and management approaches.

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  • Complication rates for single-stage versus multi-stage repairs were compared.

    • Main Results:

    • Diverticular disease was the most common cause (59%).
    • Cystoscopy (60%) and cystography (44%) demonstrated the highest sensitivity for diagnosis.
    • No significant difference in complication rates was observed between single-stage and multi-stage repair groups.

    Conclusions:

    • Single-stage repair is a safe option for enterovesical fistulas caused by diverticular or granulomatous bowel disease.
    • Staged repairs may be preferable for complex cases involving large pelvic abscesses, advanced malignancy, or significant radiation changes.