Urinary Tract Fistula

Urinary Tract Fistula is a topic covered in the 5-Minute Emergency Consult.

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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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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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