Ureteroileal fistulas.

Of the fistulas that involve the urinary and intestinal tracts vesicointestinal fistulas are the most common and nephrointestinal fistulas are infrequent. Ureteroileal fistulas are extremely rare, with only 6 previously reported cases. Three recent cases are presented to highlight current management. In all 3 patients the ureteroileal fistula developed postoperatively, including 1 after radical pelvic surgery for advanced ovarian carcinoma, 1 following failed transureteroureterostomy and 1 after a repeat left ureteral reimplant with a pelvic abscess. Infection and/or urinary leakage had a major role in these cases, similar to the previously reported fistulas. In contrast to the previously reported patients, all of whom underwent surgical excision or revision, the 3 patients described herein were managed successfully with percutaneous nephrostomy or indwelling ureteral stents. Although successful management today may bypass operative intervention in these rare fistulas most are preventable operative complications.