When is enterovesical fistula repair indicated?

Updated: Dec 05, 2018
  • Author: Joseph Basler, MD, PhD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The documented presence of a fistula that is causing symptoms or adversely affecting quality of life is an indication for surgical intervention in patients with enterovesical fistulae. Fistulae should be repaired in patients with any of the following:

  • Abdominal pain
  • Dysuria
  • Malodorous urine
  • Incontinence
  • Urinary outlet obstruction
  • Recurrent cystitis
  • Bouts of sepsis
  • Pyelonephritis

Patients at high surgical risk may be treated with medical therapy and catheter drainage but may ultimately require at least diverting surgery if symptoms persist. Patients with terminal cancer are often better treated conservatively or with simple diversions.


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