Vaginal Fistula : Causes-Symptoms-Diagnosis-Treatment

 What Is a Vaginal Fistula?

A vaginal fistula is an unusual opening that connects your vagina to another part of your body. For example, a vaginal fistula can link your vagina to your bladder, bowel, or other organs.

What Is a Vaginal Fistula?
Vaginal Fistula

A fistula is a small tunnel between two organs in the body Fistulas usually occur as a result of complications from surgery or infections Usually surgical and other medical treatments can heal most fistulas but sometimes they become chronic problems that cannot be treated easily Some common types of fistulae are: * An anal fistula which causes one area of the anus to drain directly into another part of the body through an opening in the skin around this area; for example a rectovaginal fistula could cause feces to exit through the vagina.

  1. Female Reproductive System

  • Internal reproductive organs

  1. Ovaries

  2. Fallopian tubes

  3. Uterus

  4. Cervix

  5. Placenta

  • External reproductive organs

  1. Vulva

  2. Clitoris

  3. Vagina

Medical terms

  • A vaginal fistula is an abnormal tract or opening in the vagina often leading to the bladder (vesicovaginal fistula) or rectum (rectovaginal fistula) Vaginal fistulas may be acquired occurring as a result of injury such as obstetric trauma or surgery; they are also a symptom of infections and other diseases
  • Vaginal fistulas are abnormal passageways that form between the vagina and various other organs A vaginal fistula can be either a rectovaginal fistula which connects the vagina to the rectum or an entero-vaginal fistula which connects the vagina to one of several abdominal organs such as the bladder or colon Fistulas result from prolonged obstructed labor due to any cause including childbirth injury prolonged rupture of membranes dystocia (difficult birth) cephalopelvic disproportion (large fetal head in relation to maternal pelvis) a fetus in breech presentation or obstructed
  • A canal fistula is an abnormal gap that connects your channel to a different organ, like your bladder, colon or body part. Your doctor may describe the condition as a hole in your channel that permits stool or excretion to withstand your channel.

Vaginal fistulas will develop as a result of associate degree injury, a surgery, associate degree infection or radiation treatment. regardless of the explanation for your fistula, you'll ought to have it closed by a physician to revive traditional performance.

There square measure many forms of canal fistulas:

  • Vesicovaginal fistula. Also called a bladder fistula, this opening occurs between your vagina and urinary bladder and is the type that doctors see most often.

  • Ureterovaginal fistula. This type of fistula happens when the abnormal opening develops between your vagina and the ducts that carry urine from your kidneys to your bladder (ureters).

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

  • Rectovaginal fistula. In this type of fistula, the opening is between your vagina and the lower portion of your large intestine (rectum).

  • Colovaginal fistula. With a colovaginal fistula, the opening occurs between the vagina and colon.

  • Enterovaginal fistula. In this type of fistula, the opening is between the small intestine and the vagina.

  • Bladder (vesicovaginal fistula)

  • Your ureters are the tubes that carry your pee from your kidneys to your bladder (ureterovaginal fistula).

  • Your urethra is the tube that carries your pee down from your bladder and outside of your body (through the urethrovaginal fistula).

  • Rectum is the lower part of your large intestine. A rectovaginal fistula is a hole that connects the rectum and the vagina.

  • A colovaginal fistula is an abnormal connection between the large intestine (colon) and the vagina.

  • Small intestine (enterovaginal fistula)

Symptoms Vaginal Fistula

A vaginal fistula doesn't usually hurt, but it can cause some problems. If you have a vesicovaginal fistula (an opening between your vagina and bladder), your bladder will constantly leak urine into your vagina. This can make you unable to control your urination. This means that the person is not able to control their urine and bowel movements.

You may get infected or experience pain during sexual intercourse.

Other symptoms of vaginal fistulas may include:

  • Fever

  • Belly pain

  • Diarrhea

  • Weight loss

  • Nausea

  • Vomiting

Causes Vaginal Fistula

The most common cause of tissue damage is something like:

  • Childbirth

  • Surgery to remove an organ (hysterectomy or cesarean section)

  • Pelvic, cervical, or colon cancer

  • Radiation treatment

  • Crohn's or diverticulitis is a type of bowel disease.

  • If you get an infection after giving birth, it includes after an episiotomy or tear you may have had when giving birth.

  • A traumatic injury, such as from a car accident, can happen.

Will a vaginal fistula heal on its own?

A fistula is a type of abnormal connection between two organs or structures in the body It's most commonly found between the bladder and vagina but can also form as an umbilical (belly button) fistula or occur between the rectum and vagina Fistulae are often caused by complications during childbirth A vaginal fistula will not heal on its own because it is made up of tissues that are designed to separate from one another--vaginal tissue which connects to the uterus for example The only known cure for a vaginal fistula is surgery so see your doctor immediately if you are experiencing symptoms.

Can I live with a fistula?

Infection and fistulae go hand in hand Fistulae are often present where an appendage has been amputated due to an infection that started in the appendage An example of a common type of infection leading to formation of a fistula is one that affects toes due to injury or separation from the foot by trauma or surgery.

Can antibiotics cure fistula?

No Antibiotics are used to treat the symptoms but they do not cure fistula Fistulas often recur after they have been treated with antibiotics; this is because the real cause of fistula – a weak or damaged anal sphincter muscle – has not been addressed by treatment The reinfection happens when bacteria get into the anal canal again and cause another infection.

Diagnosis Vaginal Fistula

Your doctor will do a pelvic exam to see if you have any risk factors for fistulas, like a recent surgery or infection. They will also ask about your medical history.

They may also order some tests, including: Some tests may be ordered, including: Tests may also be ordered, including:

  • Dye test.Your doctor will put a dye solution in your bladder. You'll need to cough or bear down. If you have a vaginal fistula, the dye will leak into your vagina.

  • Cystoscopy.Your doctor uses a thin device called a cystoscope to look inside your bladder and urethra for signs of problems.

  • X-rays:

    • Retrograde pyelogram.This test involves inserting a dye into your bladder and then taking an X-ray to see if there is leakage between your ureters and your vagina.

    • Fistulogram.This is an X-ray image of your fistula. It can tell your doctor if you have one or more fistulas and if other pelvic organs may be involved.

  • Flexible sigmoidoscopy.Your doctor will look at your anus and rectum with a sigmoidoscope. This thin, flexible tube has a tiny video camera at the tip.

  • CT urogram.You will have dye injected into a vein and X-rays will be taken of your vagina and urinary tract.

  • Pelvic MRI.A magnetic field and radio waves help take detailed pictures of your rectum and vagina to show the details of a rectovaginal fistula.

Treatment Vaginal Fistula

If it's a small bladder fistula, your doctor might try putting a small tube called a catheter into your bladder to drain the urine and give the fistula time to heal on its own.

They might use a special glue or plug to seal or fill the fistula. They can also give you an antibiotic to treat an infection caused by the fistula.

Some people who have fistulas need surgery. This type of surgery depends on the type of fistula and where it is. It might be done through small cuts (injuries) with cameras and tools inserted through them using laparoscopic surgery. Or the surgery might involve a regular incision with more pain and risk. A scalpel is a tool used to cut things.

If you have a vaginal fistula that connects to your rectum, your doctor might do one of the following:

  • Sew a special patch over the fistula

  • If you cut yourself, you can use tissue from another part of your body to heal the wound.

  • Cover the fistula with healthy tissue. Make a flap of it and stick it over the hole.

  • If your anus is damaged, you can fix it by fixing the muscles.

Complications Vaginal Fistula

Vaginal fistulas can be embarrassing and smelly when they leak. But they can also cause complications, like:

  • If you have a vaginal or urinary tract infection that keeps coming back, there might be something wrong with your health.

  • Hygiene problems

  • Vaginal discharge or gas that leaks out of the vagina.

  • You might have skin irritation or inflammation around your vagina or anus.

  • A swollen clump of infected tissue with pus (abscess) is dangerous and needs to be treated if it is not resolved.

  • Fistulas that come back

Women with Crohn's disease and a fistula have a high risk of later complications, such as fistulas forming again or fistulas that do not heal properly.

What should I ask my provider?

You may want to ask your healthcare provider:

  • What caused the vaginal fistula?

  • What type of vaginal fistula do I have?

  • How should I care for myself while I have this condition?

  • What are my treatment options?

  • What complications could occur from surgery?

  • Are there steps I can take to prevent getting another vaginal fistula?

General summary

  1. Vaginal fistulas are abnormal passageways that develop between the bladder or rectum and vagina They are often a result of injury such as obstructed labor where scar tissue is left behind by surgical repair The condition also occurs in obstetric fistula which is an infection of the vagina after childbirth causing obstructed labor resulting in a hole to form between the vaginal and bladder or rectal regions In severe cases vaginal fistulas can cause blood loss life threatening infections and infertility Treatment for vaginal fistulas ranges from surgery healing through conservative methods or high-risk cesarean sections if the conditions become life.

  2. Because fistulas sometimes heal on their own you can use conservative methods to treat the condition You may need surgery to cure a fistula if it is not going away or if it is getting worse with time Most of the treatment options involve injections or surgery that lets doctors cut out the infected tissue and re-route fluid flow through healthy areas of skin to prevent leakage.

  3. Bladder fistula and uterine (womb) fistula are usually caused by poor obstetric care especially during childbirth Fistula can also result from illness or injury such as a long-term infection or the improper use of catheters while in hospital It may occur because of a congenital abnormality of the bladder or uterus but this is rarer.

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