Description

A fistula vaginal is an unusual opening that forms between the vagina and another organ, like the bladder, the colon or the rectum. Your health care professional may describe a fistula vaginal as a hole in the vagina, which allows the urine, feces, or gas to pass through the vagina.

Vaginal fistulas can form after childbirth or after an injury, surgery, infection or radiation treatment. You may need surgery to repair a fistula.

There are several types of fistula vaginal. Are appointed on the basis of the location of the fistula and organs they affect:

  • Vesicovaginal fistula. It is also called a fistula of the bladder, this opening between the vagina and the urinary bladder. This is one of the most common fistulas.
  • Fistula Ureterovaginal Fistulae. This type of fistula occurs when an unusual opening forms between the vagina and the tubes that carry urine from the kidneys to the bladder. These tubes called ureters.
  • Urethrovaginal fistula. The opening forms between the vagina and the tube that carries urine out of the body, called the urethra. This type of fistula is also called a fistula, urethral.
  • Rectovaginal Fistula. In this type of fistula, the opening between the vagina and the lower portion of the large intestine, called the rectum.
  • Fistula Colovaginal. The opening occurs between the vagina and the colon.
  • Enterovaginal fistula. The opening between the intestine and the vagina.

Symptoms

Vaginal fistula symptoms may include:

  • The escape of urine or feces, or gas through the vagina.
  • Urinary tract infections often happens.
  • The urine has an unusual odor, or contains blood.
  • The Vaginal fluid called discharge that looks or smells weird.
  • Pain during sexual intercourse.
  • Pain, swelling, or irritation in the area between the vagina and the anus, called the perineum.
  • Repeated infections of the vagina.

The exact symptoms of a person will depend in part on the location of the fistula.

When to see a doctor

Get a health checkup if you believe that you have symptoms of a fistula to the vagina. Tell your health care professional if you have symptoms that affect their daily life, relationships or mental health.

Causes

Vaginal fistulas has many possible causes, including certain medical conditions and problems that can occur because of the surgery. These causes include the following:

  • Complications of the surgery.The surgeries that involve the walls of the vagina, the anus or in the rectum can cause fistulas vaginal. So can surgery in the area between the vagina and the anus, called the perineum. Fistulas may form due to reasons such as injury during surgery and post-surgical infections. Skilled surgeons can repair injuries during the operation, which reduces the risk of fistula. But complications such as fistulas are more common after surgery in people with diabetes or in people who use tobacco. The surgery to remove the uterus, called a hysterectomy, is an example of an operation that can increase the risk of a fistula to the vagina. The risk is greater if a hysterectomy is more complex. For example, the risk increases if the surgery lasts more than five hours, or if it involves a greater loss of blood or the removal of most of the surrounding tissue.
  • The birth of the lesions.A fistula vaginal can come from the tear, which sometimes occurs when the baby's head comes through the opening of the vagina. Or a fistula may form due to an infection of a surgical incision made between the vagina and the anus to help deliver a baby. This cause is not common in developed countries. Is in the hand of a long time because the baby can not move into the birth canal may increase the risk of a fistula vaginal, mainly in developing countries. That's in part because access to the delivery of emergency measures such as the C-section may be limited.
  • Crohn's disease. This condition inflames the lining of the digestive tract. If you follow your Crohn's treatment plan, you will not likely get a fistula to the vagina. Crohn's disease is a type of inflammatory bowel disease (IBD). Another type of IBD called ulcerative colitis can also lead to fistula vaginal, but the risk of that happening is even lesser.
  • Certain types of cancer and radiation therapy. Cancer of the anus, the rectum, the vagina, or the cervix may lead to a fistula to the vagina. So may cause damage to radiotherapy for the treatment of cancer in the pelvic area.
  • Diverticulitis. This condition implies that the small, bulging pouches in the digestive tract. Diverticulitis leading to a fistula vaginal is more common in older people.
  • A large amount of fecal matter stuck in the rectum. This condition is known as fecal impaction. It is also more likely to cause a fistula vaginal in an older person.

Complications of the surgery. The surgeries that involve the walls of the vagina, the anus or in the rectum can cause fistulas vaginal. So can surgery in the area between the vagina and the anus, called the perineum. Fistulas may form due to reasons such as injury during surgery and post-surgical infections. Skilled surgeons can repair injuries during the operation, which reduces the risk of fistula. But complications such as fistulas are more common after surgery in people with diabetes or in people who use tobacco.

The surgery to remove the uterus, called a hysterectomy, is an example of an operation that can increase the risk of a fistula to the vagina. The risk is greater if a hysterectomy is more complex. For example, the risk increases if the surgery lasts more than five hours, or if it involves a greater loss of blood or the removal of most of the surrounding tissue.

The birth of the lesions. A fistula vaginal can come from the tear, which sometimes occurs when the baby's head comes through the opening of the vagina. Or a fistula may form due to an infection of a surgical incision made between the vagina and the anus to help deliver a baby. This cause is not common in developed countries.

Is in the hand of a long time because the baby can not move into the birth canal may increase the risk of a fistula vaginal, mainly in developing countries. That's in part because access to the delivery of emergency measures such as the C-section may be limited.

Risk factors

A fistula vaginal has no clear risk factors.

Complications

Vaginal fistulas can lead to other health problems called complications. Complications of fistulas vaginal include:

  • Fistulas that keep coming back.
  • Course of pelvic infections.
  • The narrowing of the vagina, the anus or the rectum. This is also called stenosis.
  • Problems to become pregnant.
  • The loss of a pregnancy after 20 weeks, which is also called fetal death.

Prevention

There are steps you need to take to prevent a fistula to the vagina.

Diagnosis

Your health care professional has many ways of knowing if a fistula vaginal is the cause of your symptoms. You will be asked questions about your medical history. You'll get a physical exam, which may include a pelvic exam. You may also need other tests.

During the physical exam, your health care professional checks the outer part of the vagina, the anus and the area between the two, called the perineum. Your health care professional for symptoms such as scars, irregular vaginal discharge, leakage of urine or stool, and pockets of pus called abscesses.

A pelvic exam may also be done to check the health of your outer part of the vagina and reproductive organs. During the test, the health professional inserts one or two lubricated, gloved fingers into your vagina with one hand. At the same time, the other hand gently press down on the outer side of the lower part of the stomach. A device called a speculum can be used to open the spread of the walls of your vagina and see in your interior.

Tests

If a fistula vaginal cannot be found during a physical exam, other tests may be needed. These could include the following:

  • The dye test. In this test, your health care professional, the bladder is filled with a dye solution and asked to cough or bear down. If you have a fistula, vaginal, the dye appears in your vagina. You can also see traces of the dye in a buffer after physical exercise.
  • The cystoscopy. During this exam, the health care provider uses a hollow device that is equipped with a lens. The device is called a cystoscope. With the cystoscope, your healthcare provider can see the inside of the bladder. The interior of the small tube that carries urine out of the body, called the urethra, it can also be seen. This allows the health professional to check for any problem.
  • Pyelogram retrograde. In this test, your health care professional injects a substance into the bladder and the tubes that connect the bladder to the kidneys, called the ureters. Then, an x-ray. The X-ray image can show your health care professional if there is an opening between the urethra and the vagina.
  • Fistulogram. A fistulogram is an X-ray image of the fistula. This test can help your healthcare provider see if you have more than one fistula. Your health care professional may also be able to see what other pelvic organs can be affected by a fistula.
  • Flexible sigmoidoscopy. During this exam, the health care provider uses a thin, flexible tube with a tiny video camera on the end. This device is called a sigmoidoscope. Allows your health care professional to check the anus and rectum.
  • The computed tomography (CT) urogram. In this test, you have a contrast material is injected into a vein. Then your health care professional uses a ct scan to obtain images of the vagina and the urinary tract.
  • Magnetic resonance imaging (MRI). Magnetic resonance imaging uses a magnetic field and radio waves to produce detailed images of organs and tissues in the body. With a magnetic resonance imaging of the pelvis , your healthcare provider can see the path of a fistula between the vagina and the rectum.
  • Colonoscopy. This uses a flexible system, of the house tip of the tube to verify the changes in the large intestine and the rectum.

If the test image to find a fistula vaginal, your healthcare provider may remove a small tissue sample. This is called a biopsy. A controls laboratory of the biopsy sample to detect signs of cancer. It is not common, but some fistulas vaginal may be due to a cancer.

You may also need lab tests to help find the cause of your symptoms. These could include analysis of blood and urine.

Treatment

The treatment of a fistula vaginal depends on factors such as the type of fistula you have, its size, and if the surrounding tissue is healthy.

For a simple fistula vaginal or with few symptoms, some procedures can help the fistula to heal by itself. A simple fistula vaginal may be one that is small, or one that is not linked to cancer or radiation therapy. Procedures for assisting a simple fistula vaginal healing include:

  • Placement of a urinary catheter. A catheter is a medical device, which can sometimes treat small fistulas between the vagina and the bladder. A urinary catheter is a flexible tube that drains the bladder. It is possible that you need to use for more than three weeks.
  • The placement of ureteral stents. This procedure can treat some fistulas between the vagina and the ureters. A hollow tube called a stent is placed in the inside of the ureter to keep it open.

For a simple fistula between the vagina and the rectum, you may need to change your diet also. Your healthcare provider may also recommend supplements to make the stool softer and easier to pass.

Most often, surgery is necessary for treatment of a fistula to the vagina. Before the surgery can be done, any infection or inflammation in the tissue around the fistula vaginal should be treated. If the tissue is infected, medications called antibiotics can eliminate the infection. If the tissue is inflamed due to a condition such as Crohn's disease, medications such as biologics are used to control the inflammation.

The surgery for a fistula vaginal aims to remove the fistula tract and join the healthy tissue to close the opening. Sometimes, a flap of healthy tissue that is used to help close the area. The surgery can be performed through the vagina or the area of the stomach. Often, a type of surgery that consists of one or more small incisions can be made. This is called laparoscopic surgery. Some surgeons also the control of robotic arms with an attached camera and surgical tools.

Some people with fistulas between the vagina and rectum that need surgery to repair damage to a ring near muscle called the anal sphincter. When the anal sphincter is healthy, keeps the anus closed as reflected on the stool in the rectum.

Less often, people with fistulas between the vagina and the rectum need a procedure called a colostomy before the surgery. With a colostomy, an opening is made in the stomach area through which the stool can leave your body and collect in a bag. This helps the fistula to heal. The procedure is usually temporary. The colostomy opening is then closed for a couple of months after fistula surgery. Rarely, the colostomy is permanent.

The surgery to repair a fistula vaginal often successful, especially if you have not had the fistula for a long time. Still, some people need more than one surgery to get relief.

Symptoms and treatment of the fistula Vaginal