Urogynecology

Genital Fistula

Get help for Genital Fistulas.

Surgery Can Help FAQs

Surgery Can Help

Surgery can address the embarrassing symptoms.

A fistula is an opening between two organs that normally do not communicate with each other. According to the World Health Organization, more than 2 million women live with fistulas between the bladder and the vagina (vesicovaginal fistula) and the rectum and vagina (rectovaginal fistula), which are typically caused by a prolonged, obstructed labor in developing countries.

There are other causes, however, and the women all share symptoms that can be irritating, distressing and painful. In developing countries, women are often ostracized. In any area of the world, the involuntary loss of urine or fecal matter from the vagina is embarrassing.

Surgery can close the holes and help you lead a normal life.

FAQs

In developing countries, the most common cause is a long labor, particularly if the mother is young and has an undeveloped pelvis. In the United States, leading causes include pelvic surgery, such as hysterectomies, and pelvic radiation.

The leading symptom is uncontrollable urinary incontinence leaking through the vagina. You may or may not have pain. If you develop an infection, you might have a fever and nausea.

Your doctor may find the fistula during an exam. Additional diagnostic tests may include:

Cystoscopy.
Cystogram.
Back-filling the bladder with colored fluid to see if it leaks into the vagina.
Computerized tomography (CT) scan.
Collecting vaginal fluid for analysis.

Again, a long, difficult labor and childbirth are the most frequent causes.

Others include:

Crohn’s disease, diverticulitis or another inflammatory bowel disease.
Radiation treatment or cancer in the area.
Complications from surgery.
Vaginal trauma.

The most apparent symptom is a stool or gas coming from your vagina and not your rectum. Other symptoms include:

Pus coming from your vagina.
Vaginal discharge with an unpleasant smell.
Recurrent vaginal or urinary tract infections.
Irritation or pain in the vulva, vagina and perineum, which is the space between your vagina and anus.
Pain during sexual intercourse.

Your doctor may find the fistula during an exam. Diagnostic tests may include:

Anorectal or transvaginal ultrasound.
Methylene enema. If a tampon, inserted into the vagina, turns blue when a dye is injected into the rectum, you have a fistula.
Barium enema. Contrast dye helps the doctor pinpoint a fistula on an X-ray.
Computerized tomography (CT) scan.
Magnetic resonance imaging (MRI).
Colonoscopy.

Depending on the cause, the doctor can use surgery to close the holes. Before surgery, however, your doctor will treat any infection.

During the procedure, the surgeon will close the holes and then layer your own connective tissue between the holes to help prevent them from reopening. The area needs a good blood supply so that the tissue survives. When the surgery is correctly performed the first time, it has a high success rate.