What are the Symptoms of a Vesicoenteric Fistula?

Recognising Vesicoenteric Fistula: Key Symptoms & When to Act

A vesicoenteric fistula is an abnormal passage that forms between the bladder and the intestines. It can be characterized by an array of symptoms, particularly at the urinary and intestinal levels. 

Common urinary symptoms often involve the passage of stool in the urine (fecaluria), the presence of air or gas bubbles in urine (pneumaturia), recurring urinary tract infections, and an increased frequency or urgency to urinate. Gastrointestinal-related symptoms may consist of abdominal pain, diarrhea, and alterations in bowel habits. 

To know more about vesicoenteric fistula symptoms, keep reading! 

What is a Vesicoenteric Fistula? 

A vesicoenteric fistula, also known as enterovesical or intestinovesical fistula, involves an abnormal connection between the bowel and the bladder. Under normal circumstances, the urinary system remains entirely separate from the digestive tract. However, this type of connection can develop as a result of various underlying causes, such as: 

• Infections 
• Inflammatory diseases 
• Cancer 
• Trauma or presence of a foreign body 
• Iatrogenic causes (which may arise post-surgery or as a complication of treatment) 

In general, medical practice, the most frequent cause of these abnormal links is a bowel disease that develops adjacent to the bladder and eventually breaks through into it. Although fistulas connecting the bowel to the ureter or renal pelvis can occur, they are rare in the absence of trauma, persistent infection, or prior surgical procedures. 

What are the Symptoms of a Vesicoenteric Fistula? 

Pneumaturia is a common presenting symptom of vesicoenteric fistula and is reported in a significant proportion of patients, though exact prevalence varies across studies and underlying causes. In this the urine may look foamy, and you might experience bubbles that disrupt your stream of urine. 

Fecaluria is another characteristic symptom, though it is generally less common than pneumaturia and occurs in a variable proportion of patients depending on the underlying cause. In this case, the urine will appear to be cloudy or have a brownish discoloration. 

Other vesicoenteric fistula symptoms include: 

• Dysuria (painful urination) 
• Hematuria (blood in the urine) 
• Lower abdominal pain 

What Causes a Vesicoenteric Fistula to Form? 

Check out an overview of the causes of a vesicoenteric fistula below: 

• A colovesical fistula is a type of vesicoenteric fistula. These fistulas represent an abnormal connection between two organs, specifically the bowel and the bladder. 
• Fistulas also exist between other parts of the body, i.e., between veins and arteries, bile duct and skin, cervix and vagina, and the neck and throat. 
• The leading cause of vesicoenteric fistulas is diverticulitis, accounting for about 60% to 70% of all cases. 
• Other major contributors include cancers like colorectal, bladder, and prostate cancer, as well as Crohn’s disease. Among these, Crohn’s disease and malignancies are recognized causes of vesicoenteric fistulas, but reported proportions vary across studies and should be expressed as approximate ranges rather than fixed percentages. 

Who is Likely to Develop a Vesicoenteric Fistula? 

Though rare, vesicoenteric fistulas (VFs) are considered rare, with incidence varying by underlying disease and surgical population. Precise incidence rates are not well established in the general surgical population. They are most frequently diagnosed in individuals between the ages of 51 and 60. Men are more likely to develop this condition than women, with a male-to-female ratio of about 2:1 or 3:1. 

Additional risk factors that will make one more likely to get a vesicoenteric fistula include: 

• Surgical trauma, particularly during procedures such as a colonoscopy 
• An appendiceal abscess 
• Retained surgical instruments left in the abdomen 
• Physical trauma, like that caused by car crashes or sports injuries 

How is Vesicoenteric Fistula Diagnosed? 

If you are experiencing stool passing through your urine, you should contact a healthcare provider as soon as possible. It can be difficult for one to diagnose a vesicoenteric fistula (VF), and research has found that quite a few months can pass before one can make the diagnosis. 

Some of the most common diagnostic methods used in identifying vesicoenteric fistula are: 

1. Cystoscopy: During cystoscopy, a thin tube with a camera is gently guided into the bladder, giving the doctor a clear view of its inner lining to check for any issues. 
2. Imaging Tests: MRI and CT scans are often utilized to diagnose irregular connections in the body and are valuable diagnostic tools for VF. 
3. Barium Enema: This procedure involves injecting a contrast dye containing barium sulfate into the colon and rectum to make these areas visible on an X-ray. 

Since vesicoenteric fistulas can be dangerous to a person's health, it's essential to act quickly if there are any symptoms. Diagnosis can be tricky, but the condition is usually cured with surgery.  

Disclaimer: This article is intended for general informational and educational purposes only. Anyone experiencing symptoms such as abnormal urinary or bowel findings, recurrent infections, or persistent abdominal pain should seek prompt evaluation by a qualified healthcare professional.

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→ Symptoms of an Upper UTI Infection

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