[Sigmoid colovesical fistula associated with cancer of the sigmoid colon].
OBJECTIVE
To report one case of colovesical fistula after the diagnosis of unresponsive urinary tract infection.


METHODS
The 76-year-old patient underwent a diagnostic work up including cystography, cystoscopy and barium enema.


RESULTS
Cystography revealed an image of the sigmoid colon, and cystoscopy showed a granuloma at the bladder dome. A fistula was identified underneath. A colovesical fistula was diagnosed and several intestinal germs grew on urine cultures. Partial cystectomy and end to end anastomosis of the sigmoid colon were carried out. Pathology report showed a well-differentiated adenocarcinoma which invaded down to the bladder mucosa.


CONCLUSIONS
Inflammatory diseases are the main the etiology of colovesical fistula, followed by neoplasias. We reviewed around 170 cases reported in our country. It is important to identify the fistula by means of the gastro-intestinal series and the study of the lower urinary tract when treating patients with urinary tract infection difficult to control. We suggest the best radical therapy is surgery in a single procedure.
Yabuki
Daisuke
D
Servicio de Urologia, Hospital Universitario de Toho, Ohashi, Tokyo, Japan.
Sawada
Yoshitomo
Y
Takeuchi
Yasuharu
Y
Masuda
Eisuke
E
Satoh
Daisuke
D
Kuroda
Kanami
K
Tajima
Masaharu
M
Sawamura
Yoshikatsu
Y
Matsushima
Masahiro
M
Shibuya
Kazutoshi
K
D000230:Adenocarcinoma / Q000150:complications*; D000368:Aged; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008297:Male; D012810:Sigmoid Diseases / Q000209:etiology*; D012811:Sigmoid Neoplasms / Q000150:complications*; D001747:Urinary Bladder Fistula / Q000209:etiology*
Fístuia vesico-sigmoidea asociada con cancer de colon sigmoides.