Search

Purpose of review: Vesico-enteric fistulas (VEF) have a tremendous effect on patient quality of life. Unfortunately, clear diagnostic and management guidelines do not exist. In this article, we review the current evidence for workup and treatment of these fistulas. Additionally, new treatments are presented. Recent findings: Technological advancements in imaging modalities have shifted diagnosis from simply demonstrating the fistula to providing anatomic and pathologic information. Furthermore, continued improvement in endoscopic and laparoscopic tools may allow for treatment of fistulas with durable results. Summary: Management of the underlying disease process is key to management of VEF. Enhanced imaging techniques and improved medical therapies have allowed for better optimization prior to surgical therapy improving success rates. Additionally, endoscopic and laparoscopic treatments have allowed for more minimally invasive treatments, challenging the accepted practice of excision and repair of VEF. In the future, continued technological and medical developments will allow for better management of the underlying cause of VEF and decrease comorbidity associated with repair. [ABSTRACT FROM AUTHOR]

Aim: To describe the problems and management of rectourethral fistulas. Background: Rectourethral fistula constitutes a rare entity that poses a challenging management problem. The condition is either congenital or acquired. The clinical findings suggestive of RUF include pneumaturia, faecaluria, and urine leakage per rectum. Methods: This study was based on English research literature, mainly by searching PubMed bibliographic database. Results: Diagnosis of a rectourethral fistula is difficult and often based on history alone. In rare cases, non-operative management has been successful, but the majority of patients require surgical intervention. A wide variety of procedures have been described for RUF repair. Conclusion: Rectourethral fistula represents a complex management problem for any surgeon. Surgical treatment of RUF is technically demanding and requires collaboration with rectal surgeons. [ABSTRACT FROM AUTHOR]

Emphysematous cystitis is a rare disease with a high mortality rate. Generally elderly women with diabetes mellitus are affected. Diagnosis is made radiologically using plain abdominal X‑ray or computed tomography. The therapy includes urine drainage, antibiotic treatment and hyperglycaemic control to avoid progress of the infection and the development of complications. In the current report we present a case of a 79-year-old woman with uncontrolled diabetes mellitus and an incidental diagnosis of emphysematous cystitis. [ABSTRACT FROM AUTHOR]

This paper presents two unusual fistulae between the rectum and the lower urinary tract in adults, one a posttraumatic fistula following dilatation of a sigmoid colon stricture and the other a congenital anomaly. In both cases a contrast enema was negative; in one case a voiding cystourethrogram was negative. The fistula was demonstrated in case 1 by repeating the enema and having the patient raise his intraabdominal pressure, and in case 2 by having the patient hold while attempting to pass flatus during a cystogram, which demonstrated gas bubbles entering the bladder. [ABSTRACT FROM AUTHOR]