Colovesical and rectovesical fistulas
R. M. King, R. W. Beart Jr and D. C. McIlrath
Colovesical or rectovesical fistulas develop because of a congenital
abnormality, a traumatic incident, or an underlying disease, such as
inflammation or cancer. Inflammation, either diverticulitis or Crohn's
disease, was the cause of fistula in 73 (67%) of 109 patients with
colovesical or rectovesical fistulas seen at the Mayo Clinic, Rochester,
Minn, between 1965 and 1980. Sixty-six of the 73 patients had colovesical
fistulas, and 64% of them underwent resection and anastomosis in one stage.
Cancer of the cervix, prostate, bladder, colon, or rectum was responsible
for 27 fistulas, equally divided between colovesical and rectovesical
types. Only seven (26%) could be treated by one-stage anterior resection.
Fifteen patients required fecal diversion with or without resection of
bowel. At follow-up, 80 patients were alive; only two (one with prostatic
cancer and one with cervical cancer) had recurrence of fistula.
