Coloseminal Vesicle Fistula: Report of a Case and Review of the Literature

Abstract

Despite their anatomic proximity, communication between the colorectum and seminal vesicle is an uncommon event. We describe the first reported case of a fistula between the colon and seminal vesicle as a complication of diverticulitis. This case report is followed by a literature review of other reported cases of fistula formation between the seminal vesicle and the colon.

Cauda Equina Syndrome Secondary to Complicated Diverticulitis

“…Colovesical fistulas are more common in men than in women because the uterus usually shields the bladder from being penetrated by the fistula [3, 10]. However, a fistula can form to whichever organ the inflammatory process tracks, and has been described in many unexpected sites, such as the seminal vesicle [11]. A colospinal fistula as in our patient has, to our knowledge, never been described.…”

Coloseminal Fistula Complicating Sigmoid Diverticulitis

“…Seven cases have so far been reported: complicating surgery for rectal or prostatic neoplasms [1,2,3], after radiotherapy [4,5], a complication of Crohn's disease [6], and only 1 case with diverticular disease [7]. Clinical presentation is usually subacute with symptoms mimicking colovesical fistulas, namely pneumaturia and dysuria.…”

“…Clinical presentation is usually subacute with symptoms mimicking colovesical fistulas, namely pneumaturia and dysuria. Abdominal CT scans with rectal contrast or water enema, or pelvic MRI with water enema appear to be the best diagnostic modalities [4,7]. Medical treatment options, such as antibiotherapy or finasteride, allow for symptom reduction before surgical management in order to reduce seminal secretion or percutaneous drainage [8].…”

“…Medical treatment options, such as antibiotherapy or finasteride, allow for symptom reduction before surgical management in order to reduce seminal secretion or percutaneous drainage [8]. Reported surgical procedures include vasovasostomy, vasotomy, colostomy, or surgical resection [4,7]. …”

Unusual cause for recurrent epididymo‐orchitis: fistula from rectal stump to seminal vesicle

“…Fistulae between the gastrointestinal and urogenital tracts are most commonly colovesical, with the aetiology including diverticular disease (65–75% of cases), cancer (10–20% of cases) and Crohn’s disease (5–7%) . There are very few cases of seminal vesicle‐rectal fistulae described, with only 13 individuals identified and none resulting in severe purulent epididymo‐orchitis requiring orchidectomy.…”