In areas where women have no health care nearby,
vaginal fistulas are much more common. After days of pushing a baby that does
not fit through the birth canal, very young mothers can have severe vaginal,
bladder, or rectal damage, sometimes causing fistulas.
What are the symptoms?
A vaginal fistula is usually painless. But a fistula lets urine or feces
pass into your vagina. This is called incontinence. And it can cause
soiling problems that you cannot control.
If you have a vesicovaginal fistula, you most
likely have fluid leaking or flowing out of your vagina.
have a rectovaginal, colovaginal, or enterovaginal fistula, you most likely
have foul-smelling discharge or gas coming from your vagina.
genital area may get infected or sore.
How is a vaginal fistula diagnosed?
Your symptoms are the most clear signs of a vaginal fistula. Your
doctor will want to talk about your symptoms and about any surgery, trauma,
or disease that could have caused a fistula. For a physical exam, your doctor
will use a speculum to look at the vaginal walls. You may have
other tests, such as:
The use of dye in the vagina (and maybe the
bladder or rectum) to find all signs of leakage.
check for infection.
Blood test (complete blood count) to check for
signs of infection in your body.
Your doctor may also use an X-ray, endoscope or MRI to get a clear look
and check for all possible tissue damage.
How is it treated?
If you have a vaginal fistula, you will most likely need surgery
to repair it. Before surgery, your doctor will see whether the tissue is
healthy or needs to heal first.
You may need medicine or wound care to heal
the tissue before surgery.
If you have inflammatory bowel disease,
your doctor will not do surgery during a symptom flare.
have a large rectovaginal fistula, you may first have a colostomy. This is to keep the fistula clear for the
surgery. After the fistula repair heals, the colostomy is taken out.
After fistula repair surgery, be sure to follow your doctor’s
instructions. See your doctor right away if you have signs of infection, such
as a fever, tenderness, swelling, or redness.
Other Places To Get Help
American Congress of Obstetricians and Gynecologists
Other Works Consulted
Katz VL (2012). Postoperative counseling and management. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 583-621. Philadelphia: Mosby.
Lentz GM (2012). Anatomic defects of the abdominal wall and pelvic floor. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 453-474. Philadelphia: Mosby Elsevier.
Wong M, Ozel B (2010). Fistulae. In Management of Common Problems in Obstetrics and Gynecology, 5th ed., pp. 328-332. Chichester, UK: Wiley-Blackwell.
ByHealthwise Staff Primary Medical ReviewerSarah Marshall, MD – Family Medicine Kathleen Romito, MD – Family Medicine Martin J. Gabica, MD – Family Medicine Specialist Medical ReviewerDeborah A. Penava, BA, MD, FRCSC, MPH – Obstetrics and Gynecology