SIGMOIDO-VESICAL FISTULAS DUE TO DIVERTIC ULITIS

From 1984 to 1993, 11 patients (7 men and 4 women, mean aged 70 years) underwent surgical procedure for sigmoido-vesical fistula due to dive rticulitis. Fecaluria and/or pneumaturia was present in 10 patients. T he diagnosis of sigmoido-vesical fistula due to diverticulitis was con firmed by urologic and colonic investigations. All patients underwent surgical treatment. One patient underwent creation of a diverting colo stomy alone because of a poor general status. Definitive surgical corr ection of the fistula with resection of the diverticular colon was att empted in the remaining 10 patients, including colo-rectal anastomosis . A temporary diverting colostomy was performed in 5 cases. There was no post operative death. One small wound infection occured. All the di verting colostomies have been closed, meanly 2 months after the operat ion. Concerning long-term results, 3 patients died from an independant reason. All the other patients are alive and asymptomatic from the ur ologic as well as the digestive point of view. Based on these results, we advocate single stage repair, including correction of the fistula and resection of the diverticular colon with cole rectal anastomosis, in cases of good local and general conditions.