Enterovesical and Enterogenital Fistulae

A fistula is an abnormal connection between two epithelialized hollow spaces or organs. Enterovesicle (EVF) and enterogenital fistulas (EGF) occur between the bowel and genitourinary system (e.g. bladder, ureter, prostate, uterus and vagina). Various congenital and pathological processes precipitate a communication. Although the entities discussed are uncommon, the societal, institutional and economic impact associated with its morbidity warrants discussion. The diagnosis of EVF and EGF can be challenging and is often delayed. Though diagnostic imaging plays a pivotal role in establishing the site, course, aetiology and complexity of fistulae, these entities remain difficult to demonstrate using common diagnostic modalities owing to the intimacy of surrounding soft tissue structures. Non-operative, endoscopic, open and laparoscopic approaches have been used with variable outcomes. This chapter focuses on the aetiologies, presentations, diagnostic processes and treatments of EVF and EGF.