Fistulas are abnormal connections between two structures. Most commonly, they involve an area of the rectum or anus to an associated structure surrounding the anus. A rectourethral fistula is a connection between the rectum or anus and the urethra, which is the tube that empties the bladder and allows you to urinate. A fistula here may develop following surgery of the prostate, radiation to the pelvis for cancer or for other reasons.
Intestinal fistulas often present with urinary complaints. Patients express air, gas bubbles or stool when they urinate. They may have recurrent urinary tract infections, have pain in the area or leak urine in the stool.
Diagnosis usually requires either direct visualization of the connection (with a scope or colonoscopy), by injection of radiologic contrast into the area or by visual examination of the bladder and associated tubes. This requires evaluation by a professional who can sort out all of these symptoms.
Surgery may be required and often involves a team approach with a urologist, as this can be a complex process.