Review of 31 vesicointestinal fistulas: diagnosis and management.

Review of 31 cases of enterovesical fistulas treated at the Departments of Urology and General Surgery during the period 1970-1982. In 20 cases (64.5%) the underlying cause was a carcinoma (overall colorectal neoplasm) and in 7 cases (23%) it was an inflammatory disease. Gouverneur's syndrome (suprapubic pain, frequency, dysuria, urinary pain and tenesmus) was present in 17 patients (54.8%). Pneumaturia and fecaluria were present in 18 and rectal micturition in only 5. The diagnosis was based on cystograms in 66.6% of the patients. Other explorations oriented us towards the location of the fistula but only confirmed it in a low percentage (10-30%). The treatment undertaken varied in each case depending on the etiology and the patient's condition: medical (3%), derivative and palliative surgery (23%) and radical surgery (68%).