Recto-vesical fistula is an anomalous communication (fistulous tract) between the bladder and the rectum. The common etiologies are diverticulitis, Crohn’s disease, irradiation, traumatic, bladder or colo-rectal cancer and tuberculosis.
Common symptoms of presentation are fecaluria (presence of feces in the urine), pneumaturia (passage of gas in the urine), hematuria (presence of blood or clots in the urine), intestinal symptoms, abdominal pain, and fever/chills.
Evaluation: urine test (urinalysis) shows food fibers, fecal particles, bacteria, white blood cells and red blood cells.
Cystography shows fistulous tract and bladder inflammation, as seen in this picture, which is a diagnostic/evaluation method barely used because of availability of CT scans.
Later I will give you the fast facts about treatment of this condition.
It would be nice to have CT scans (hope UroCT) and cystoscopy.
If no light is found, I would order an cystography.
Regards.
I have had a gram-negative multi drug resistant UTI since May of 2012. There have been several CT scans, a cystoscopy, and attempt to treat this with about half a dozen antibiotics, with no result. In Nov. 2012 I devloped a peri-anal cyst which the surgeon said was caused by a staph infection. She raised the possibility of a recto-visical fistula, and I am wondering how this can be definitively identified and treated, if this is the case. I have had four blood transfusions due to hemorrhaging from the urinary tract. I would appreciate any information that would be helpful. Thank you.
Sure, Mr. Ajayi. I will post in management of recto-vesical fistula, soon and let you know
need more on management