Unusual Cause for Recurrent Urinary Infections: Colovesical Fistula Revisited

Colovesical fistula is the presence of a communication between the colon and the bladder, either directly or via an intervening abscess cavity (foyer intermediare). These are the most common type of fistulous communication between the urinary bladder and the bowel. First record of Colovesical fistula was in AD 200 by Rufus of Epheus. The first monograph on the case was produced by Cripps in 1888. [1] The relative frequency of colovesical fistulae is difficult to ascertain owing to multiple etiological factors, and also few surgical procedures could be complicated by such fistulae. The incidence in patients with diverticular disease, the most common cause of colovesical fistula, is generally accepted to be 2 %, though per-operatively occurrence is documented to be higher. Only 0.6 % of carcinomas of the colon lead to fistula formation.