A vaginal fistula is an abnormal opening that connects your vagina to another organ, such as your bladder, colon or rectum. Your doctor might describe the condition as a hole in your vagina that allows stool or urine to pass through your vagina.
Vaginal fistulas can develop as a result of an injury, a surgery, an infection or radiation treatment. Whatever the cause of your fistula, you may need to have it closed by a surgeon to restore normal function.
There are several types of vaginal 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.
a vaginal fistula can link your vagina to your:
- Ureters, the tubes that carry your pee from your kidneys to your bladder
- Urethra, the tube that carries your pee down from your bladder and outside your body
- Rectum, the lower part of your large intestine
- Large intestine
- Small intestine
Vaginal fistulas can be upsetting and embarrassing because they leak and cause bad smells. But they can also cause complications, like:
- Vaginal or urinary tract infections that keep coming back
- Hygiene problems
- Stool or gas that leaks through the vagina
- Irritated or inflamed skin around your vagina or anus
- An abscess -- a swollen clump of infected tissue with pus that could be life-threatening if it’s not treated
- Fistulas that come back
Women who have Crohn’s disease and develop a fistula have a high risk of getting complications, such as fistulas forming again later or fistulas that don’t properly heal.
What Causes Vaginal Fistulas?
Most often, the culprit is tissue damage that can result from any of the following:
- Abdominal surgery (hysterectomy or C-section)
- Pelvic, cervical, or colon cancer
- Radiation treatment
- Bowel disease like Crohn’s or diverticulitis
- Infection (including after an episiotomy or a tear you had when you gave birth)
- Traumatic injury, such as from a car accident
What’s the Treatment?
Some fistulas may heal on their own. If it’s a small bladder fistula, your doctor might want to try putting a small tube called a catheter into your bladder to drain the pee and give the fistula time to heal by itself.
He might also want to try a special glue or plug made of natural proteins to seal or fill the fistula. Still, many people need surgery. What kind of surgery you get depends on the type of fistula and where it is. It could be laparoscopic, where your doctor makes small cuts (incisions) and uses cameras and tools. Or it could be abdominal surgery, where you get a regular incision with a tool called a scalpel.
For a vaginal fistula that connects to your rectum, your doctor might:
- Sew a special patch over the fistula
- Take tissue from your body to close the fistula
- Fold a flap of healthy tissue over the fistula
- Fix the muscles of your anus if they are damaged
Your doctor will likely also prescribe an antibiotic to treat infection caused by the fistula. And ist good to attend medical camps for free check-ups if you doubt your symptoms. This can save you money as well.