What is the prevalence of enterovesical fistula?

Updated: Dec 24, 2020
  • Author: Joseph Basler, MD, PhD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Colovesical fistulae are the most common type of fistulous communication between the urinary bladder and the bowel. The relative frequency of colovesical fistulae is difficult to ascertain because of the numerous potential etiologies, including multiple disease processes and surgical procedures. [4]

The incidence of fistulae in patients with diverticular disease, the most common cause of colovesical fistula, is accepted to be 2%, although some referral centers have reported higher percentages. Only 0.6% of carcinomas of the colon lead to fistula formation. [5]

Colovesical fistulae are more common in males, with a male-to-female ratio of 3:1. The lower incidence in females is thought to be due to interposition of the uterus and adnexa between the bladder and the colon. In women, other types of fistulae (typically iatrogenic, such as enterovaginal, ureterovaginal, and vesicovaginal) are more common than colovesical fistulae. [5] Women who present with colovesical fistulae are commonly older and/or have a history of hysterectomy. Uterine atrophy or absence may be predisposing etiologies.

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