Vaginal fistula: Know all about this health complication

A vaginal fistula can be troublesome for women, considering it is an opening that develops between the vaginal walls and another organ.
vaginal dryness
Menopause can show up as increased vaginal dryness or itching. Image courtesy: Shutterstock
Dr Parameshwara CM Updated: 17 Jul 2022, 20:12 pm IST
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More than 50,000 women worldwide develop a vaginal fistula every year, according to the World Health Organization (WHO). Globally, it affects women in developing countries, where access to healthcare and reproductive health education and services is limited.

The fistula is a serious and often destructive medical condition. Surprisingly, many women who suffer from this condition are unaware that they have it. Read more about the condition, the treatment options available, and how you can prevent this condition from reoccurring.

What is a vaginal fistula?

A vaginal fistula is an unusual tunnel-like opening that develops between the walls of the vagina and another organ, such as the bladder, ureters, urethra, rectum, large intestine, or small intestine.

Varied reasons can cause damage to tissue in your vaginal wall and lead to the formation of a hole where it doesn’t belong.

vaginal opening
Vaginal care is important. Image courtesy: Shutterstock

Based on the location and organs affected, there are the following types of vaginal fistula:

1. Ureterovaginal fistula: A fistula that happens when an unusual opening develops between the vagina and the ureters, which are the tubes that carry urine from the kidneys to the urinary bladder.

2. Urethrovaginal fistula: This type of fistula, also called a urethral fistula, includes an opening that occurs between the vagina and the urethra, which is the tube that carries urine out of the body.

3. Vesicovaginal fistula: One of the most common types of fistulas, vesicovaginal fistula is characterised by an opening that occurs between the vagina and the urinary bladder. It is also called a bladder fistula.

4. Rectovaginal fistula: In this type of fistula, the opening occurs between the vagina and the rectum, which is the lower portion of the large intestine. It is also called an anal vaginal fistula.

5. Enterovaginal fistula: This type of fistula is characterised by an opening between the small intestine and the vagina.

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6. Colovaginal fistula: In the case of a colovaginal fistula, the opening occurs between the vagina and the colon.

Causes and symptoms of vaginal fistula

The main culprit of vaginal fistulas is tissue damage to the vaginal walls. Some of the most commonly studied causes of vaginal tissue damage are:

* Vaginal tearing or prolonged labour during childbirth
* Pelvic or abdominal surgeries like hysterectomy or C-section
* Cervical, pelvic, or colon cancer
* Inflammatory bowel diseases (IBD) like ulcerative colitis and Crohn’s disease
* Traumatic injury, such as a car accident
* Radiation treatment

Vaginal fistula symptoms that occur when the opening is between the vagina and the urinary system organs:

* Urinary incontinence
* Constant urine leakage
* Painful intercourse
* Skin irritation to your vagina
* Abdominal pain
* Nausea or vomiting
* Foul-smelling vaginal discharge
* Vaginal or rectal bleeding
* Painful intercourse
* Recurrent vaginal infections, kidney infections, or UTIs Treatment of Vaginal Fistula

abdominal pain
Vaginal fistula can give you abdominal pain. Image courtesy: Shutterstock

Treatment of vaginal fistula

The diagnosis for vaginal fistula includes a pelvic exam and a series of tests, including complete blood counts, urinalysis, fistulogram X-ray, urogram, pelvic MRI, flexible sigmoidoscopy, and cystoscopy.

Based on the diagnosis of the fistula type, appropriate treatment is given. Following are some treatments:

* Antibiotics: For infections and/or bowel disorders.
* Ureteral stents: Also called kidney stents, ureteral stents keep your ureters open while the ureterovaginal fistula gets better.
* Temporary self-catheterisation: This drains your bladder while the vesicovaginal fistula heals.

Most people dealing with vaginal fistulas need surgery, which depends on the type of fistula.

Typically, a fistula repair is done by using your own, surgical, or lab-made tissue to close the opening.

It also ensures complete recovery.

In achieving a successful repair, bladder closure is much more important than vaginal closure. Talk to your surgeon about the steps to prevent getting another vaginal fistula.

A vaginal fistula is a serious problem that can make life unpleasant for sufferers. If you think you have a vaginal fistula or urinary complications or want to avoid the recurrence of the condition, you need to treat it properly from the beginning. You can contact us to book an appointment and get the best treatment for vaginal fistula.

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About the Author

Dr Parameshwara CM MBBS, MS, Fistula Surgeon, AYU Health Hospitals ...Read More

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