Is vesicolithotomy with bladder wash the answer for rectovesical fistula secondary to neglected vesical stone? Complicated presentation but simple management.

It is extremely rare that the urinary bladder stones cause vesicorectal fistulas. Urinary tract infection and poor fluid intake are the main etiologies that precipitate vesical stone formation, and subsequent rectovesical fistula. We present a complicated case of neglected vesical stone, which recurred 3 times. The patient presented with passage of urine per rectum leading to fecal incontinence. He was managed only with vesicolithotomy and bladder wash with eventual spontaneous closure of the rectovesical fistula.