Vaginal Fistula
What is a vaginal fistula?
A vaginal fistula is an abnormal opening between the vagina and another organ. A vesicovaginal fistula is an abnormal connection between the bladder and the vagina; a rectovaginal fistula is an abnormal opening between the rectum and the vagina; an enterovaginal fistula is an abnormal opening between the small bowels and the vagina. These openings may result in incontinence.
What are the symptoms of a vaginal fistula?
The symptoms of a vaginal fistula are urine or feces being released through the vagina. Women who have a vaginal fistula may feel embarrassed by the condition, as it can cause vaginal leakage and unpleasant smells.
What are the causes of a vaginal fistula?
The most common cause of vaginal fistulas is prolonged labor. Fistulas can also be caused by urologic or pelvic surgery, an infection or cancer. Sometimes, conditions like Crohn’s disease or diverticulitis can lead to a vaginal fistula. Accidents and traumatic injuries can also lead to a vaginal fistula.
How is a vaginal fistula treated?
Nonsurgical treatment may be an option for some patients with this condition. For vaginal fistulas that are detected early and are less than half a centimeter in size, a catheter can often be inserted to see if the fistula will repair itself. Small, uncomplicated rectovaginal fistulas can sometimes be treated with a plug that is placed in the rectum. This is often used to treat patients who are not good surgical candidates.
Vaginal fistulas are typically repaired surgically through the vagina. This procedure has the lowest risk of complication. However, depending on the location and complexity of the fistula, it may be necessary to perform the surgery through the abdomen. Repairing fistula through the abdomen can be done via robotic surgery, which typically minimizes the size of the incision and the amount of pain for the patient.
If a patient presents with a clean fistula and is in good health, the success rate of fistula surgery is high. The procedure, like any surgery, does carry the risk of bleeding, infection and damage to surrounding organs.
