[Entero-urinary fistula]

Abstract

Aim: To present the results of the diagnostic and the management of entero-urinary fistulae.

Methods: we performed a retrospective study on 18 patients with entero-urinary fistulas that had been diagnosed and treated at the Hospital Ibn Sina Rabat during the period spanning 1989-2006

Results: The surgery was the main etiology of fistulas. The location was colo-vesical in 2 cases, prostato-rectal in 7 cases, vesico-rectal in 2 cases, uretero-colic in 3 cases, uretro-rectal in 3 cases and uretero-ileal in 1 case. The clinical manifestations were principally urological in the form of recurrent urinary infection, pneumaturia and fecaluria. The most useful diagnostic techniques were voiding retrograde cystourethrography and abdominal CT scan showing the fistulae in 12 cases. Treatment was by surgery in 15 cases. The transperitoneal way was adopted for the upper tract fistulas and the way of York Mason preferred for the lower urinary tract fistulas. No complications have been reported in the follow-up of these patients.

Conclusion: Although the diagnosis of entero-urinary fistulae seems easy, the management remains difficult. It depends on its location and on the general state of the patient. He must be appropriate to avoid a recurrence which the management would be more complicated.