Colovesicle Fistula

What Is a Colovesical Fistula?
A colovesical fistula is an abnormal connection between the colon and the bladder, allowing stool or gas to enter the urinary tract. This can lead to significant discomfort and complications if left untreated.

Causes
The majority of colovesical fistulas (over two-thirds) are caused by diverticular disease. Other causes include:

• Colorectal cancer
• Inflammatory bowel disease, especially Crohn’s disease
• Surgery involving the colon or bladder
• Cancer of nearby organs
• Radiation therapy affecting the pelvic area

Symptoms
Symptoms occur due to the passage of intestinal contents into the bladder and may include:

• Bubbles in the urine (pneumaturia)
• Brownish or cloudy urine
• Blood in the urine
• Painful or burning urination
• Recurrent urinary tract infections
• Abdominal pain
• Diarrhea
• Severe complications such as sepsis, which can be life-threatening

Diagnosis
Colovesical fistulas can be reliably diagnosed using a CAT scan. Additional diagnostic procedures may include:

• Cystoscopy – Inserting a small camera into the bladder to view the fistula
• Barium enema – Imaging test to better visualize the colon and surrounding tissues

Treatment
Surgical repair is the definitive treatment for colovesical fistulas. The type of surgery depends on the cause, severity, and location of the fistula. Most fistulas occur between the sigmoid colon and the bladder. Surgery typically involves removing the affected portion of the colon.

Our surgeons often use minimally invasive techniques, such as laparoscopic or Da Vinci® robotic-assisted surgery, which allow for greater precision, faster recovery, reduced pain, and fewer complications.