Surgical treatment of colovesical fistula: the value of a one-stage procedure

The records of all patients (43) with colovesical fistulas at Ochsner Clinic were reviewed retrospectively. The presenting symptoms are more often related to the bladder and not to the colon; fecaluria and pneumaturia are almost pathognomonic. The diagnosis may be difficult to obtain on proctoscopy,...

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Bibliographic Details
Published inSouthern medical journal (Birmingham, Ala.) Vol. 69; no. 1; p. 40
Main Authors Ray, J E, Hughes, J P, Gathright, Jr, H B
Format Journal Article
LanguageEnglish
Published United States 01.01.1976
Subjects
Adult
Age Factors
Aged
Colectomy
Colonic Diseases - diagnosis
Colonic Diseases - surgery
Cystoscopy
Female
Humans
Intestinal Fistula - diagnosis
Intestinal Fistula - surgery
Male
Middle Aged
Postoperative Complications
Proctoscopy
Sex Factors
Urinary Bladder Fistula - diagnosis
Urinary Bladder Fistula - surgery
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Summary:The records of all patients (43) with colovesical fistulas at Ochsner Clinic were reviewed retrospectively. The presenting symptoms are more often related to the bladder and not to the colon; fecaluria and pneumaturia are almost pathognomonic. The diagnosis may be difficult to obtain on proctoscopy, cystography, or intravenous pyelograms. Roentgenograms after barium enema and cystoscopy are the best means of diagnosis, though operation is necessary in some instances for definitive diagnosis. Primary resection and anastomosis with closure of the bladder has been successful in our experience with little morbidity and only one postoperative death. The controversy regarding primary colon resection in treatment of colovesical fistulas is perplexing. We do not believe that it is "foolhardy" to save the patient extra time, morbidity, and expense by doing one instead of three procedures. Primary resection of the colon with simple closure of the bladder is our recommended treatment for chronic colovesical fistula. We have had no recurrences.
ISSN:0038-4348
DOI:10.1097/00007611-197601000-00015