Management of Enterovesical Fistulas: Analysis of 33 Patients Treated at a Single Tertiary Reference Center

Adam Bobkiewicz, Maciej Borejsza-Wysocki, Krzysztof Szmyt, Adam Studniarek, Tomasz Banasiewicz and Lukasz Krokowicz

Department of General Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poland

^*Correspondance to: Lukasz Krokowicz 

 PDF  Full Text DOI: 10.25107/2474-1647.3046

Abstract

Background: Enterovesical Fistula (EVF) is defined as a pathological communication between the intestinal lumen and the urinary bladder. EVF is a relatively rare finding in a complicated diverticular disease, inflammatory bowel disease, malignancy, radiation or trauma. We presented our ten-year experience in the field of EVF management. Methods: Thirty-three patients were enrolled into this study. This retrospective study investigated the clinical presentation, underlying pathology, diagnostic tests, and surgical management including urinary bladder, perioperative complications and the long-term outcome obtained by administering a phone survey as a follow-up. Results: The most common underlying etiologies of EVF were Crohn?s disease (n=11) and colorectal cancer (n=10). The most common symptom was a nonspecific suprapubic pain reported in 60.6% of patients. The pathognomonic symptoms such as pneumaturia and faecaluria were present in 51.5% and 39.4% of the patients, respectively. Barium enema was the diagnostic study of choice performed in 63.6% of the patients. In 14 patients, the resection with primary anastomosis was performed. Ten patients developed perioperative complications. No recurrent fistulas were observed at the time of follow-up. Conclusion: Resection with primary anastomosis is feasible and safe in the majority of patients. In cases of advanced colorectal cancer, we recommended Hartmann?s procedure as a method of choice. Surgery performed in well-experienced centers determines the effectiveness of the EVF management characterized by the low mortality rate and perioperative complications.

Keywords

Enterovesical fistula; Intestinal fistula; Primary anastomosis; Surgery

Cite the article

Bobkiewicz A, Borejsza-Wysocki M, Szmyt K, Studniarek A, Banasiewicz T, Krokowicz L. Management of Enterovesical Fistulas: Analysis of 33 Patients Treated at a Single Tertiary Reference Center. Clin Surg. 2021; 6: 3046.