泌尿道感染在基層醫療中是相當常見的病症，一般而言，男性泌尿道感染的發生率遠比女性來的低，導致泌尿道感染的原因相當多，但是在這些眾多的病因中，結腸膀胱管症是很少見的。本病例是一位52歲男性病患，最近一年半以來因為反覆性泌尿道感染及排尿困難，多次就醫後症狀並未完全改善而至本科門診求治。入院前一次門診中，病人抱怨氣尿、糞尿等不尋常的症狀，這些正是腸道膀胱瘻管症特有的，最後終於在膀胱鏡檢查中發現一個瘻管開口。病人接受部分膀胱切除併膀胱縫合術及部分乙狀結腸切除併端對端吻合術治療 ，手術後復原情況良好，不再有排尿疼痛、頻尿、氣尿或糞尿的情形。本文的目的，希望能藉此病例提醒基層醫師，在面對反覆性泌尿道感染時，可藉由詳細的病史詢問、尿液的觀察，仔細推敲是否有罕見病因的可能性，進而安排適當的檢查來確立診斷。此外，藉由回顧相關文獻，希望能讓基層醫師對結腸膀胱瘻管症有更深一層的瞭解。 (台灣家醫誌2003; 13: 46-52) 　　Urinary tract infection (UTI) is a very common disorder seen in primary care practice. Generally speaking, the prevalence of UTI in men is much lower than that in women. Among the multiple disorders that may contribute to UTI, colovesical fistula is considered a relatively uncommon one. We report the case of a 52-year-old male patient with a one-and-a-half year history of recurrent UTI with dysuria. With the last episode, he also complained of pneumaturia and fecaluria. The latter two symptoms were pathognomonic of enterovesical fistula, and a colovesical fistula was found on cystoscopy. The patient underwent partial cystectomy with repair of the bladder wall and partial resection of the sigmoid colon with end-to-end anastomosis. He was asymptomatic on follow-up. We report this case and review the literature in order to deepen primary care physicians' understanding of colovesical fistula and to emphasize the importance of a detailed history and careful urinalysis for determining the etiology of recurrent UTI in men.