Objectives. To review our experience with enterovesical fistulas in or
der to determine the most accurate diagnostic studies and most effecti
ve method of treatment. Methods. A retrospective record review of 76 p
atients who were diagnosed and treated for enterovesical fistulas over
a 12-year period was performed. Data collection focused on presenting
symptoms, urinary disease process, diagnostic studies, and methods of
management. Results. Diverticular disease was the primary etiologic f
actor in the majority of patients (59%), with colonic malignancy, gran
ulomatous bowel disease, and radiation therapy accounting for the majo
rity of the remainder. Cystoscopy (60%) and cystography (44%) were the
most sensitive diagnostic studies. There was no statistical differenc
e in the complication rate between groups treated with single or multi
stage repair. Conclusions. One-stage repair of enterovesical fistulas
can be safely performed when the cause is diverticular or granulomatou
s bowel disease. Staged repairs may be more judicious in patients with
large intervening pelvic abscesses or those in whom advanced malignan
cy or radiation changes are present.