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The etiology of fistulas can be either renal tuberculosis or calculous pyonephrosis.
In the majority of early reports, this pathology was tuberculosis, but more recently, calculous pyonephrosis has been the predominant underlying cause.
6) reported a complication involving injury to a patient's colon with a calculous pyonephrosis that had dense adhesions in their study of laparoscopic pyelolithotomy.