A six years' experience with 41 cases of enterovesical fistula in a Tertiary National Hospital in Indonesia: A retrospective study. (January 2022)

• Record Type: Journal Article
• Authors: Widia, Fina; Firman, Muhammad; Irdam, Gampo Alam; Syaiful, Ridho Ardhi
• Is Part Of: Annals of medicine and surgery. Volume 73(2022)
• Publication Date: 2022-01
• Subjects: Intestinal fistula -- Urinary fistula -- Enterovesical fistula -- Surgery; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.103102
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: The incidence of Enterovesical Fistula (EVF) is relatively low. Currently, there is no agreement about the best methods for EVF management. This study was performed to investigate the characteristics of EVF to find the optimal diagnostic and management pattern. Methods: Data were collected retrospectively from the medical record at Cipto Mangunkusumo Hospital. Patients diagnosed with EVF between January 2014 and April 2019 were included. They were evaluated for demographics, characteristics, diagnostic modalities, and treatment modalities. Results: From 41 patients, 26 (63.3%) are male, and 15 (36.6%) are female. Peak incidence was 51–60 years old. The most common symptoms are fecaluria found in 32 (78%) patients. The common etiology is gastrointestinal cancer found in 17 (41.5%) patients, followed by gynecologic cancer and diverticulitis found in both 9 (22%) patients. The rectovesical fistula was seen in 25 (61%) patients with an advanced stage rectosigmoid cancer, followed by colovesical in 14 (34.1%) of patients with sigmoid diverticulitis (p 0.038). The common diagnostic modalities performed are cystoscopy in 32 (78%), followed by colonoscopy in 11 (26.8%) patients. The preferred modalities that were used in most cases were surgery in 35 (85.4%) patients. A two-stage surgical approach was used in 28 (68.3%) patients. Conclusion: The incidence of EVF is uncommon. Malignancy was the leading cause of EVF in this study. Combined diagnostic modalities are recommended in EVF cases. The two-stage surgical approach was the preferred modality. Further prospective studies are mandatory to analyze this condition. Highlights: - Enterovesical fistula (EVF) incidence is relatively low with no uniformly agreed management. - Malignancy was the most common cause of the fistula. - The underlying disease were significantly correlate to the anatomical location of the fistula (p-value = 0.038). - Surgical approach (Two-stage) was the preferred modality used in most cases.