Introduction. The article describes a clinical case demonstrating the difficulties of diagnosis and aspects of surgical treatment of diverticular disease complicated by the formation of a colovesical fistula.

   Discussion. A colovesical fistula is formed due to the destruction of the diverticulum wall due to chronic inflammation and the formation of a junction with a neighboring organ or the environment. Most often, colovesical fistulas are a consequence of a complicated course of diverticular disease, but the causes may also be inflammatory diseases of the colon, as well as tumor diseases of the intestine or urinary system. During the diagnosis and choice of treatment tactics for patients with diverticular disease complicated by the formation of a colovesical fistula, the participation of doctors of different specialties is necessary: coloproctologists, surgeons, urologists and oncologists. Without radical treatment, the risk of relapse is extremelyhigh. In this regard, timely diagnosis, a multidisciplinary approach and an adequate amount of surgical intervention are the key to successful treatment of patients with colovesical fistulas.

   Conclusion. Surgical intervention in complicated forms of diverticular disease is the only possible option for radical treatment, while the choice of access and scope of intervention should be determined individually in each case and take into account the prevalence of the process, anatomical features and experience of the surgeon.