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.