How are enterovesical fistulas categorized?

Updated: Dec 24, 2020
  • Author: Joseph Basler, MD, PhD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

A fistula is an abnormal communication between two epithelialized surfaces. Vesicoenteric fistulae, also known as enterovesical or intestinovesical fistulae, occur between the bowel and the bladder. Vesicoenteric fistulae can be divided into four primary categories based on the bowel segment involved, as follows [3] :

  • Colovesical (70%)
  • Rectovesical (including rectourethral) (11%)
  • Ileovesical (16%)
  • Appendicovesical (7%)

Colovesical fistula is the most common form of vesicointestinal fistula and is most often located between the sigmoid colon and the dome of the bladder. [3]   Rectourethral and rectovesical fistulae are observed in the postoperative setting, such as after prostatectomy, as a consequence of chronic infection or tissue destruction that accompanies massive decubiti, or in the setting of acute infections such as Fournier gangrene.


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