[Urodigestive fistulae: the diagnosis and treatment of 76 cases]. / Fístulas urodigestivas: diagnóstico y tratamiento de 76 casos.

OBJECTIVES: Urodigestive fistulas are secondary complications of inflammatory, traumatic or neoplastic disease and can occasionally be difficult to diagnose, although the typical symptoms of pneumaturia and fecaluria should make the urologist and surgeon suspect the presence of a fistula, determine its etiology and location. The present study reviews our experience in the diagnosis and treatment of this pathology. METHODS: We reviewed the records of 76 patients with urodigestive fistula that had been diagnosed and treated over a period of 23 years. The form of presentation, usefulness of the diagnostic techniques and treatment options were analyzed. RESULTS: The location was vesicointestinal in 52 cases, rectourethral in 19, renointestinal in 4 and urethrointestinal in 1.

Management and treatment of eighteen rectourethral fistulas.

There is only rare and scanty literature explaining the different surgical techniques and results for rectourethral fistulas. Here we present a review of 18 patients with rectourethral fistula. In half of the cases Bevan-Mason repair was undertaken with success.

Review of 31 vesicointestinal fistulas: diagnosis and management.

Review of 31 cases of enterovesical fistulas treated at the Departments of Urology and General Surgery during the period 1970-1982. In 20 cases (64.5%) the underlying cause was a carcinoma (overall colorectal neoplasm) and in 7 cases (23%) it was an inflammatory disease. Gouverneur's syndrome (suprapubic pain, frequency, dysuria, urinary pain and tenesmus) was present in 17 patients (54.8%). Pneumaturia and fecaluria were present in 18 and rectal micturition in only 5. The diagnosis was based on cystograms in 66.6% of the patients. Other explorations oriented us towards the location of the fistula but only confirmed it in a low percentage (10-30%). The treatment undertaken varied in each case depending on the etiology and the patient's condition: medical (3%), derivative and palliative surgery (23%) and radical surgery (68%).

[Adenocarcinoma in addition to bladder exstrophy. Apropos a case and a review of the literature]. / Adenocarcinoma sobre extrofia vesical. A propósito de un caso y revisión de la literatura.

Herein we describe a case of adenocarcinoma complicating exstrophy of the bladder in a 59-year-old patient. The morphologic, histochemical and immunohistochemical analyses revealed a colonic glandular adenocarcinoma. The two hypotheses relative to its pathogenesis are briefly discussed. To date, 106 cases have been reported in the literature.