What is a Colovesical fistula?

A colovesical fistula (CVF) is an abnormal connection between the colon and urinary bladder. Although they are uncommon, CVFs can cause significant morbidity, affect quality of life, and may lead to death, usually secondary to urosepsis [1,2].

What can cause a Colovesical fistula?

The most common cause of colovesical fistula is diverticulosis; however, it may be caused by malignant diseases, Crohn’s disease, radiation, etc. The underlying mechanism is the direct extension of a ruptured diverticulum or secondary erosion of a diverticular abscess into the bladder [9, 10].

Can a Colovesical fistula heal itself?

The goal of conservative treatment is for the fistula to close and heal on its own. However, surgery may still be necessary in cases where the fistula does not heal on its own. Because colovesical fistula may be a complication of diverticulitis, make sure you follow the doctor’s orders in treating diverticular disease.

What is Colovesical?

Colovesical fistula is a rare condition that occurs when there’s a connection between the colon and the bladder, allowing fecal matter to enter the bladder. Treatment generally involves surgery. WakeMed’s team of colorectal surgeons are experienced with treating this uncommon and painful condition.

How do you fix a Colovesical fistula?

Colovesical fistulae can almost always be treated with resection of the involved segment of colon and primary reanastomosis. Fistulae due to inflammation are generally managed with resection of the primarily affected diseased segment of intestine, with repair of the bladder only when large visible defects are present.

How is a Colovesical fistula diagnosed?

The diagnosis of colovesical fistula is predominately a clinical one, however, cystoscopy was the most accurate test to detect fistulae (46.2%) followed by barium enema (20.1%). Barium enema was the most sensitive test to detect stricture formation (70.6%).

Can fistula be managed without surgery?

Treatment with fibrin glue is currently the only non-surgical option for anal fistulas. It involves the surgeon injecting a glue into the fistula while you’re under a general anaesthetic. The glue helps seal the fistula and encourages it to heal.

What is the cause of diverticulosis?

Diverticula usually develop when naturally weak places in your colon give way under pressure. This causes marble-sized pouches to protrude through the colon wall. Diverticulitis occurs when diverticula tear, resulting in inflammation, and in some cases, infection.

Is a Colovesical fistula painful?

The most common symptoms of colovesical fistula are urinary urgency, dysuria, tenesmus, suprapubic pain, pneumaturia, fecaluria, hematuria, and UTI.