Urinary Tract Fistula

Basics

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

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