eMedicine Specialties > Urology > Fistulas

Colovesical Fistula: Follow-up

Author: Joseph Basler, MD, PhD, Chief, Section of Urology, Audie Murphy Veterans Affairs Hospital; Associate Professor, Department of Surgery, Division of Urology, University of Texas Health Science Center, Bexar County Hospital
Coauthor(s): Angela Kamerer, MD, Attending Urologist, Gaston Urological Associates; Ann S Fenton, MD, MPH, Staff Physician, Department of Surgery, Division of Urology, Wilford Hall Air Force Medical Center
Contributor Information and Disclosures

Updated: Oct 8, 2007

Outcome and Prognosis

In a retrospective record review of 76 patients diagnosed with enterovesical fistula over a 12-year period, the complication rate in those treated with single-stage repair was not statistically different from that in patients who underwent multistage repair.20

In general, the overall outcome and prognosis are excellent in patients with non–radiation-induced or cancer-induced fistulae. Such patients usually respond well to resection of the diseased colon and have no significant urinary sequelae.

The prognosis in patients with colon carcinoma and fistulization is less favorable because the involvement of the bladder usually heralds a more aggressive tumor that often is metastatic at the time of detection.

Radiation-induced fistulae are more likely to recur, but the long-term patient prognosis may be better if the malignancy for which the radiation was administered has been controlled.

Future and Controversies

Future treatment of typical enterovesical fistulae may focus on development and refinement of laparoscopic techniques to allow resection with a minimal hospitalization. New modalities in neoadjuvant chemotherapy may allow further bladder preservation strategies. Trends in radiation oncology that permit minimization of collateral organ damage (eg, conformal external beam radiotherapy) and the use of tumor-specific radiosensitizing agents may be highly useful in preventing radiation-induced fistulae. Improved surgical techniques, including laparoscopic procedures that greatly enhance visualization of the operative field, hold promise for fewer fistula-related complications of gynecologic and urologic procedures.

 


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References
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Further Reading

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Keywords

colovesical fistula, colovesical fistulae, enterovesical fistula, intestinovesical fistula, vesicocolic fistula, rectovesical fistula, ileovesical fistula, appendicovesical fistula, pneumaturia, fecaluria, urinary tract infections, UTIs, bowl disease, vesicoenteric fistula, recto-urethral fistula, diverticular disease, Crohn disease, appendicitis, imperforate anus, diverticulitis, Crohn colitis, Meckel diverticulum, genitourinary coccidioidomycosis, pelvic actinomycosis, colorectal cancer, prostatectomy, laparoscopic inguinal hernia repair, Gouverneur syndrome, sigmoid diverticular disease

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Contributor Information and Disclosures

Author

Joseph Basler, MD, PhD, Chief, Section of Urology, Audie Murphy Veterans Affairs Hospital; Associate Professor, Department of Surgery, Division of Urology, University of Texas Health Science Center, Bexar County Hospital
Joseph Basler, MD, PhD is a member of the following medical societies: American Urological Association, Society for Basic Urologic Research, Society of University Urologists, Society of Urologic Oncology, and Southwestern Oncology Group
Disclosure: Nothing to disclose.

Coauthor(s)

Angela Kamerer, MD, Attending Urologist, Gaston Urological Associates
Angela Kamerer, MD is a member of the following medical societies: American Medical Association, American Urological Association, and Southern Medical Association
Disclosure: Nothing to disclose.

Ann S Fenton, MD, MPH, Staff Physician, Department of Surgery, Division of Urology, Wilford Hall Air Force Medical Center
Ann S Fenton, MD, MPH is a member of the following medical societies: American Urological Association
Disclosure: Nothing to disclose.

Medical Editor

Erik T Goluboff, MD, Program Director, Department of Urology, Assistant Professor, Columbia-Presbyterian Medical Center, Columbia University
Erik T Goluboff, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society of Clinical Oncology, American Urological Association, Medical Society of the State of New York, New York Academy of Medicine, Phi Beta Kappa, and Society for Basic Urologic Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf, Jr, MD, FACS, David A Bloom Professor of Urology, Director, Division of Minimally Invasive Urology, Department of Urology, University of Michigan Medical Center
J Stuart Wolf, Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Nothing to disclose.

Chief Editor

Stephen W Leslie, MD, FACS, Founder and Medical Director of the Lorain Kidney Stone Research Center, Clinical Assistant Professor, Department of Urology, Medical College of Ohio
Stephen W Leslie, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, National Kidney Foundation, and Ohio State Medical Association
Disclosure: Nothing to disclose.

 
 
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