Skip to main content

Enterovesical and Enterogenital Fistulae

  • Chapter
  • First Online:
Textbook of Emergency General Surgery

Abstract

A fistula is an abnormal connection between two epithelialized hollow spaces or organs. Enterovesicle (EVF) and enterogenital fistulas (EGF) occur between the bowel and genitourinary system (e.g. bladder, ureter, prostate, uterus and vagina). Various congenital and pathological processes precipitate a communication. Although the entities discussed are uncommon, the societal, institutional and economic impact associated with its morbidity warrants discussion. The diagnosis of EVF and EGF can be challenging and is often delayed. Though diagnostic imaging plays a pivotal role in establishing the site, course, aetiology and complexity of fistulae, these entities remain difficult to demonstrate using common diagnostic modalities owing to the intimacy of surrounding soft tissue structures. Non-operative, endoscopic, open and laparoscopic approaches have been used with variable outcomes. This chapter focuses on the aetiologies, presentations, diagnostic processes and treatments of EVF and EGF.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pugh JI. On the pathology and behaviour of acquired non-traumatic vesico-intestinal fistula. Br J Surg. 1964;51:644–57.

    Article  CAS  PubMed  Google Scholar 

  2. Farooqi N, Tuma F. Intestinal fistula. Treasure Island, FL: StatPearls; 2021.

    Google Scholar 

  3. Basler JAE. Enterovesical Fistula: WebMD; 2020 [updated 24th Dec 2020]. https://emedicine.medscape.com/article/442000-overview

  4. Golabek T, Szymanska A, Szopinski T, Bukowczan J, Furmanek M, Powroznik J, et al. Enterovesical fistulae: aetiology, imaging, and management. Gastroenterol Res Pract. 2013;2013:617967.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Shaydakov ME, Pastorino A, Tuma F. Enterovesical Fistula. Treasure Island, FL: StatPearls; 2021.

    Google Scholar 

  6. Scozzari G, Arezzo A, Morino M. Enterovesical fistulas: diagnosis and management. Tech Coloproctol. 2010;14(4):293–300.

    Article  CAS  PubMed  Google Scholar 

  7. Tuma F, McKeown DG, Al-Wahab Z. Rectovaginal fistula. Treasure Island, FL: StatPearls; 2021.

    Google Scholar 

  8. Keady CHD, Joyce M. When the bowel meets the bladder: optimal management of colorectal pathology with urological involvement. World J Gastrointest Surg. 2020;12(5):208–25.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sardinha TC, Yebara SM, Wexner SD. Surgical therapy: mutual and combined aspects—enterourinary fistula. In: Davila GW, Ghoniem GM, Wexner SD, editors. Pelvic floor dysfunction. Philadelphia, PA: Springer; 2006.

    Google Scholar 

  10. Balsara KP, Dubash C. Complicated sigmoid diverticulosis. Indian J Gastroenterol. 1998;17(2):46–7.

    CAS  PubMed  Google Scholar 

  11. ER R. Rectovaginal fistula. In: Beck D. SS, Wexner S, editor. Fundamentals of anorectal surgery. 3rd ed. Philadelphia, PA: Springer; 2019.

    Google Scholar 

  12. Champagne BJ, McGee MF. Rectovaginal fistula. Surg Clin North Am, Table of Contents. 2010;90(1):69–82.

    Google Scholar 

  13. Schecter WP, Hirshberg A, Chang DS, Harris HW, Napolitano LM, Wexner SD, et al. Enteric fistulas: principles of management. J Am Coll Surg. 2009;209(4):484–91.

    Article  PubMed  Google Scholar 

  14. Karamchandani MC, West CF Jr. Vesicoenteric fistulas. Am J Surg. 1984;147(5):681–3.

    Article  CAS  PubMed  Google Scholar 

  15. De Ridder D. An update on surgery for vesicovaginal and urethrovaginal fistulae. Curr Opin Urol. 2011;21(4):297–300.

    Article  PubMed  Google Scholar 

  16. Lawes DEJ. Rectovaginal and rectourethral fistula. In: Zbar AP, Wexner SD, editors. Coloproctology. 1st ed. Springer; 2010. p. 169–84.

    Chapter  Google Scholar 

  17. Charua-Guindic L, Jimenez-Bobadilla B, Reveles-Gonzalez A, Avendano-Espinosa O, Charua-Levy E. Incidence, diagnosis and treatment of colovesical fistula. Cir Cir. 2007;75(5):343–9.

    PubMed  Google Scholar 

  18. Graber P. Prostatorectal fistulas. In: Marti MC, Givel J-C, editors. Surgery of anorectal diseases. Berlin: Springer; 1990.

    Google Scholar 

  19. Gray MR, Curtis JM, Elkington JS. Colovesical fistula after laparoscopic inguinal hernia repair. Br J Surg. 1994;81(8):1213–4.

    Article  CAS  PubMed  Google Scholar 

  20. Levenback C, Gershenson DM, McGehee R, Eifel PJ, Morris M, Burke TW. Enterovesical fistula following radiotherapy for gynecologic cancer. Gynecol Oncol. 1994;52(3):296–300.

    Article  CAS  PubMed  Google Scholar 

  21. Ansari MS, Nabi G, Singh I, Hemal AK, Pandey G. Colovesical fistula an unusual complication of cytotoxic therapy in a case of non-Hodgkin’s lymphoma. Int Urol Nephrol. 2001;33(2):373–4.

    Article  CAS  PubMed  Google Scholar 

  22. Crispen PL, Kansas BT, Pieri PG, Fisher C, Gaughan JP, Pathak AS, et al. Immediate postoperative complications of combined penetrating rectal and bladder injuries. J Trauma. 2007;62(2):325–9.

    PubMed  Google Scholar 

  23. Driver CP, Anderson DN, Findlay K, Keenan RA, Davidson AI. Vesico-colic fistulae in the Grampian region: presentation, assessment, management and outcome. J R Coll Surg Edinb. 1997;42(3):182–5.

    CAS  PubMed  Google Scholar 

  24. Pontari MA, McMillen MA, Garvey RH, Ballantyne GH. Diagnosis and treatment of enterovesical fistulae. Am Surg. 1992;58(4):258–63.

    CAS  PubMed  Google Scholar 

  25. Kwon EO, Armenakas NA, Scharf SC, Panagopoulos G, Fracchia JA. The poppy seed test for colovesical fistula: big bang, little bucks! J Urol. 2008;179(4):1425–7.

    Article  PubMed  Google Scholar 

  26. Kaisary AV, Grant RW. “Beehive on the bladder”: an indication of colovesical disease. Br J Urol. 1984;56(1):35–7.

    Article  CAS  PubMed  Google Scholar 

  27. Lavery IC. Colonic fistulas. Surg Clin North Am. 1996;76(5):1183–90.

    Article  CAS  PubMed  Google Scholar 

  28. Fiocchi C. Closing fistulas in Crohn’s disease—should the accent be on maintenance or safety? N Engl J Med. 2004;350(9):934–6.

    Article  CAS  PubMed  Google Scholar 

  29. Nevo Y, Shapiro R, Froylich D, Meron-Eldar S, Zippel D, Nissan A, et al. Over 1-year followup of laparoscopic treatment of enterovesical fistula. JSLS. 2019;23(1)

    Google Scholar 

  30. Woods RJ, Lavery IC, Fazio VW, Jagelman DG, Weakley FL. Internal fistulas in diverticular disease. Dis Colon Rectum. 1988;31(8):591–6.

    Article  CAS  PubMed  Google Scholar 

  31. Borseth KF, Acharya G, Kiserud T, Trovik J. Incidence of gynecological fistula and its surgical treatment: a national registry-based study. Acta Obstet Gynecol Scand. 2019;98(9):1120–6.

    Article  PubMed  Google Scholar 

Further Reading

  • Beck D, Steele S, Wexner S, editors. Fundamentals of anorectal surgery. 3rd ed. Philadelphia, PA: Springer International Publishing; 2019.

    Google Scholar 

  • Clark S. Colorectal surgery: a companion to specialist surgical practice. 6th ed. St. Louis, MO: Elsevier; 2018.

    Google Scholar 

  • Strickland M, Burnstein M, Cohen Z, et al. Colovesical fistula 2019 June 24. UpToDate (Internet) 2021.

    Google Scholar 

  • Townsend C, Beauchamp RD, Evers BM, et al. Sabiston textbook of surgery-the biological basis of modern surgical practice. 20th ed. Philadelphia, PA: Elsevier; 2016.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesco Piscioneri .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Naidu, K., Piscioneri, F. (2023). Enterovesical and Enterogenital Fistulae. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_90

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-22599-4_90

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-22598-7

  • Online ISBN: 978-3-031-22599-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics