Fecaluria (UK ~ faecaluria) is the medical term for the presence of fecal particles in the urine as a result of passing feces through the urethra when urinating (voiding). It is a fairly uncommon urinary problem and is almost always associated with a fistula between the colon or rectum and the bladder (enterovesical fistula). Less frequently, it may be due to a fistula between the rectum and urethra or colon and ureter.

The sight of fecal particles in the urine should not lead to a diagnosis of fecaluria unless the following has been excluded :

  • Simultaneous defecation prior to, during or after urinating while seated on the toilet
  • Presence of feces on the groin area
  • Remnants of fecal particles from prior use of the toilet
  • Blood clots in the urine (voiding, menstrual)

In women, a fistula between the vagina and colon (enterovaginal fistula) that arises for many of the same reasons as an enterovesicular fistula should be excluded.

An enterovesical fistula (colon-bladder) also results in pneumaturia which is the passing of gas bubbles in the urine. This is a result of gas (flatus) entering the bladder through the fistula and passing out while voiding or gas-producing microorganisms entering the bladder from the colon. Bladder pain, painful urination (dysuria) and recurrent or persistent UTI’s (urinary tract infections) may also be reported. Blood in the urine (hematuria), malodorous urine (smelly urine), tenesmus (urging) and incontinence may also be present.

Causes of Fecaluria

Although uncommon, the most common causes of fecaluria includes :

  • Surgery (post-operatively)
  • Inflammatory bowel disease (more common in Crohn’s disease)
  • Rectal cancer
  • Bladder cancer
  • Diverticulitis (diverticular abscess)
  • Trauma (blunt force or penetrating)

Less frequently, the following may result in fecaluria :

  • Meckel’s diverticulum
  • Infections of the genitourinary system or pelvis – coccidioidomycosis), actinomycosis
  • Appendicitis

References

  1. Enterovesical Fistula. Emedicine Medscape

Article reviewed by Dr. Greg. Last updated on October 12, 2010