2023 Volume 62 Issue 3 Pages 159-163
Background : Fecaluria occurs as a result of fistula formation between the intestinal tract and the urinary tract. Fecaluria and pneumaturia are frequent findings in cases of enterovesical fistulas. To date, we have encountered three cases of enterovesical fistula in which fecal material was detected on urinary cytology.
Cases : Case 1 was a man in his 60 s who underwent further medical examination for pneumaturia and hematuria. Urinary cytology revealed atypical cells and fecal materials. The patient was eventually diagnosed as having an enterovesical fistula associated with sigmoid colon cancer.
Case 2 was a man in his 60 s who consulted a doctor for fever. Fecal material was detected in the urinary sediment prepared for urinalysis before he was referred to our hospital. At our hospital also, urinary cytology revealed fecal materials, and the patient was diagnosed as having an enterovesical fistula associated with rectal cancer.
Case 3 was a man in his 50 s who consulted a doctor for fever and pain during urination. The patient was referred to our hospital with suspected enterovesical fistula. He was eventually diagnosed as having an enterovesical fistula associated with sigmoid diverticulitis. Urinary cytology revealed fecal materials. Surgical resection was performed in all three cases, and adjuvant chemotherapy was administered for Case 1 and Case 2.
Conclusion : If a urine specimen shows fecal materials, the possibility of enterovesical fistula should be considered. Urine testing is simple and non-invasive. We believe that urinary cytology will help with the diagnosis and should be performed aggressively in suspected cases.
