Fístula colovesical de origen diverticular

Abstract

The main causes of colovesical fistulas are diverticular disease of the colon and colon carcinoma. Aim: To analyze the results of the surgical treatment of colovesical fistulas of diverticular origin. Material and Methods: Retrospective analysis of all patients operated for a colovesical fistula of diverticular origin. Results: From a total of 141 patients subjected to a colon excision for diverticular disease, 18 had a colovesical fistula. The latter, compared to patients without fistulas were male in a higher proportion, were younger and had more concomitant diseases. Pneumaturia was reported in 83% and urine fecal soiling in 56%. In two thirds of patients, the fistula appeared in the absence of a diverticular crisis. Abdominal CAT scan demonstrated the fistula in 80% of cases. It was complemented with barium enema and cystoscopy. Excision with immediate anastomosis was the surgical procedure used in 94% of patients, without sequelae or relapse, after a mean follow up of 74 months. No patient died during the procedure or required a new intervention. Conclusions: Colovesical fistulas are most common in young men with associated diseases and their treatment of choice, with good long term results, is primary excision.