Is operation always necessary for enterovesical fistulas in Crohn's disease?

We have followed 11 patients with Crohn's disease and enterovesical fistulas prospectively for up to 21 years. Seven patients underwent resection for complications other than the fistula; the fistula had been present up to 5 years in this group. Four patients have being followed medically for 1-21 years since a fistula was recognized. In no patient of either group has renal impairment developed. We suggest that enterovesical fistula by itself is not an indication for surgical intervention.