A 12-YEAR EXPERIENCE WITH ENTEROVESICAL FISTULAS

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.