**Core Concept**
A colovesical fistula is an abnormal connection between the colon and the bladder, leading to the passage of fecal material into the urinary bladder. This condition often results from a complication of diverticulitis, inflammatory bowel disease, or abdominal trauma.

**Why the Correct Answer is Right**
The formation of a colovesical fistula involves the erosion of the colonic mucosa into the adjacent bladder wall, typically due to inflammation or infection. This process can occur in the setting of diverticulitis, where the inflammation from a diverticulum can spread to the bladder wall, creating a fistulous tract. The presence of a colovesical fistula can lead to symptoms such as pneumaturia (passage of gas in the urine), hematuria, or fecaluria.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not accurately describe the typical presentation of a colovesical fistula. While abdominal pain may be present, it is not the most characteristic symptom.

**Option B:** This option is incorrect as it is not a common complication of colovesical fistula. However, patients with a colovesical fistula may experience urinary tract infections or sepsis if the fistula becomes infected.

**Option C:** This option is incorrect as it describes a different type of fistula. A vesicocolic fistula is a fistula that connects the bladder to the colon, but it is not the same as a colovesical fistula, which connects the colon to the bladder.

**Option D:** This option is incorrect as it is not a specific characteristic of colovesical fistula. While a colovesical fistula may be caused by a variety of conditions, including diverticulitis, it is not specifically associated with a high risk of cancer.

**Clinical Pearl / High-Yield Fact**
A colovesical fistula often presents with pneumaturia or fecaluria, which can be mistaken for urinary tract infections or other conditions. Remember to consider a colovesical fistula in patients with unexplained symptoms of urinary tract infection or abdominal pain.

**Correct Answer:** D.