Description

Urinary tract fistulas can form between any part of the urinary tract and structures in the thoracic cavity, the abdominal cavity, the pelvis, and the skin

Etiology

• Colovesical fistula:
  • Usually complication of primary GI disease such as diverticular disease (most common), Crohn disease, or colon carcinoma
  • Iatrogenic (postsurgical or radiation treatment most common)
  • Urethral disruption from trauma
  • More common in males
• Vesicovaginal, urethrovaginal, and ureterovaginal fistulas:
  • Vesicovaginal fistula is the most common acquired fistula of the urinary tract
  • Etiology varies with geography (developed vs developing countries):
    • In developed countries, it is usually due to injury to the structures during surgery, pelvic pathology, radiation therapy, or injuries incurred in the healing process. Radiation-induced fistulas may not present for months to years after exposure
    • In developing countries, it is usually due to obstructed labor and obstetric trauma