Colovesical and rectovesical fistulas.

Colovesical or rectovesical fistulas develop because of a congenital abnormality, a traumatic incident, or an underlying disease, such as inflammation or cancer. Inflammation, either diverticulitis or Crohn's disease, was the cause of fistula in 73 (67%) of 109 patients with colovesical or rectovesical fistulas seen at the Mayo Clinic, Rochester, Minn, between 1965 and 1980. Sixty-six of the 73 patients had colovesical fistulas, and 64% of them underwent resection and anastomosis in one stage. Cancer of the cervix, prostate, bladder, colon, or rectum was responsible for 27 fistulas, equally divided between colovesical and rectovesical types. Only seven (26%) could be treated by one-stage anterior resection. Fifteen patients required fecal diversion with or without resection of bowel. At follow-up, 80 patients were alive; only two (one with prostatic cancer and one with cervical cancer) had recurrence of fistula.