Objective: Colo-vesical fistulas (CVF) are a complication of inflammatory or neoplastic diseases of the lesser pelvis. Although the clinical diagnosis is obvious in the presence of pneumaturia or faecaluria, a number of patients require complementary diagnostic and/or pretreatment investigations. The objective of this study was to analyse the management of these patients in order to define the place and cost-effectiveness of complementary investigations.
Material and methods: This retrospective study was based on 37 patients with a colo-vesical fistula, secondary to sigmoid diverticulitis in 60% of cases.
Results: Cystoscopy was the most cost-effective examination for the diagnosis of CVF with a sensitivity of 94%. The preoperative assessment of CVF and the underlying disease was optimally performed by a combination of cystoscopy, opaque enema and CT.
Conclusions: Our study defined the place of the various examinations in the assessment of colo-vesical fistula, but the value of magnetic resonance imaging, not performed in this series, remains to be defined.