Vaginal Fistula

A vaginal fistula is an abnormal opening that connects the vagina with another organ, such as the bladder, colon, or rectum. Your doctor may diagnose the condition as an opening in your vagina that allows stool or urine to pass through the vagina.

Vaginal fistulas can occur because of an injury, surgery, infection, or radiotherapy. Regardless of the cause of the fistula, you may need to have it closed by a surgeon to restore normal function in this area.

There are several types of vaginal fistulas:

Vesicovaginal fistula

The opening occurs in this type between the vagina and urinary bladder and this is the most common type of vaginal fistula.
Ureterovaginal fistula

This type of fistula occurs when an abnormal opening develops between the vagina and the tubes that carry urine from the kidneys to the bladder (ureter).
Urethrovaginal fistula

In this type of fistula, also called a urethral fistula, the opening occurs between the vagina and the tube that carries urine outside the body (urethra).
Rectovaginal fistula

In this type of fistula, the opening is between the vagina and the lower part of the large intestine (rectum).
Colovaginal fistula

In this type of vaginal fistula, the opening occurs between the vagina and colon
Enterovaginal fistula:

In this type of fistula, the opening occurs between the small intestine and the vagina.

Causes

The main causes of vaginal fistulas include:

A vaginal fistula may occur as a complication of any surgery done in the abdomen, such as a hysterectomy or a cesarean delivery.
Bowel diseases such as Crohn’s disease or colitis.
Pelvic, cervical or colon cancer
Radiation therapy.
Infections that occur because of surgery or after childbirth

Symptoms

The symptoms of the vaginal fistula vary according to its length and location in the vagina. The fistula itself does not cause any pain, but it causes a number of symptoms including:

Gases and unpleasant smell coming out of the vagina
Foul-smelling discharge or pus exuding from the vagina
Fecal leakage into the urine
Recurrent urinary tract infections
Urinary incontinence
Diarrhea and rectal pain
Inflammation around the urethra, constant urge to itch
Burning sensation during urination
Pain during intercourse
Nausea and abdominal pain

If some of the above symptoms are noticed, the patient should visit and consult the doctor immediately. The fistula may represent the first sign of a medical problem that poses a risk to the patient’s life; For example, the problem may be an inflamed abscess filled with pus, or in other cases, cancer. Diagnosing the fistula and determining its cause is an important and essential part of developing an appropriate plan for treating the vaginal fistula.

Treatment

Some types of vaginal fistula will heal on their own, but in case the patient suffers from the above-mentioned symptoms of vaginal fistula, she must urgently see a specialist to diagnose and treat the fistula. If the size of the fistula is small, the doctor may place a small tube called a catheter in the bladder; this tube empties urine until the fistula recedes and disappears, thereby allowing the body to treat itself. The doctor may sometimes use a special glue made of natural proteins to close the fistula; however, many patients need surgery to get rid of the fistula, and the type of surgery depends on the type and location of the vaginal fistula; Some of these surgeries may be done endoscopically through a small incision, while others may be done with a scalpel through a larger incision.

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