Discussion
Seminal vesicle-rectal fistula is frequently associated with ano-rectal manipulations such as surgery for lower rectal cancer or instrumental recto-genital interventions.
Seminal vesicle-rectal (SV-R) fistulation is an uncommonly reported complication and as such there is no algorithm for the management of these patients.(1,2)
SV-R fistula is an extremely rare occurrence essencialy associated with low anterior resection for rectal cancer. Only 12 cases have ever been described in the literature (1,2).
On review of the literature it is widely accepted that fever and pneumaturia are the commonest presenting symptoms. Fever is described in 10 of 13 cases [3-4,5-6] and pneumaturia in 10 of 13 cases [1-7,8-2].
A fistula between the bowel and the urinary tract usually presents with pneumaturia followed by infection of the urinary tract.
It could also be due to a congenital anomaly[9-10], or more rarely a complication of a different diseases such as diverticulitis and crohn’s desease [11]. Other studies report a risk of 1-4% in patients with diverticular disease [12].
At our knowledge our patient is the only case of idiopatic Seminal vesicle-rectal fistula.
Unfortunately we lost contact of the patient.
The standard treatment of these pathological communications is surgical treatment. Communication with the seminal vesicles described in this case has not yet been described in the literature anywhere. Therefore, there is no standard procedure for solving this situation.it can be conservative using antibiotics.