Vaginal Fistula

Overview

A vaginal fistula is a rare and complex medical condition that involves the formation of an abnormal opening between the vagina and another organ, such as the bladder, colon, or rectum. This condition can be caused by various factors, including childbirth, injury, surgery, infection, or radiation treatment. In this article, we will delve into the details of vaginal fistulas, including their types, causes, risk factors, symptoms, prevention, complications, diagnosis and evaluation, treatment and management, and when to see a doctor.

Types of Vaginal Fistula

Vaginal fistulas can be classified into several types based on the location of the fistula and the organs they affect. These types include:

1. Vesicovaginal Fistula: Also known as a bladder fistula, this type of fistula forms between the vagina and the urinary bladder. This is one of the most common types of vaginal fistulas.
2. Ureterovaginal Fistula: This type of fistula occurs when an abnormal opening forms between the vagina and the ureters, which are tubes that carry urine from the kidneys to the bladder.
3. Urethrovaginal Fistula: Also known as a urethral fistula, this type of fistula forms between the vagina and the urethra, which is the tube that carries urine out of the body.
4. Rectovaginal Fistula: In this type of fistula, the opening forms between the vagina and the rectum, which is the lower portion of the large intestine.
5. Colovaginal Fistula: This type of fistula occurs when an abnormal opening forms between the vagina and the colon.
6. Enterovaginal Fistula: The opening in this type of fistula forms between the small intestine and the vagina.

Causes of Vaginal Fistula

Vaginal fistulas can be caused by various factors, including:

1. Childbirth: Vaginal fistulas can occur after childbirth due to prolonged labor, trauma during delivery, or infection.
2. Injury: Trauma to the pelvic area or genital region can cause a vaginal fistula to form.
3. Surgery: Certain surgical procedures, such as hysterectomy or bowel surgery, can increase the risk of developing a vaginal fistula.
4. Infection: Infections such as pelvic inflammatory disease (PID) or urinary tract infections (UTIs) can increase the risk of developing a vaginal fistula.
5. Radiation Treatment: Radiation therapy for cancer can increase the risk of developing a vaginal fistula.

Risk Factors of Vaginal Fistula

Several risk factors have been identified for vaginal fistulas, including:

1. Age: Women over 50 are at higher risk of developing a vaginal fistula.
2. Previous Surgery: Women who have had previous surgery in the pelvic area or genital region may be at higher risk of developing a vaginal fistula.
3. Infection: Women who have had previous infections in the pelvic area or genital region may be at higher risk of developing a vaginal fistula.
4. Smoking: Smoking has been linked to an increased risk of developing a vaginal fistula.

Symptoms of Vaginal Fistula

Preventions of Vaginal Fistula

While there are no guaranteed ways to prevent vaginal fistulas from forming, there are several steps that can be taken to reduce the risk:

1. Maintaining good hygiene: Practicing good hygiene and keeping the genital area clean can help reduce the risk of developing an infection.
2. Avoiding smoking: Quitting smoking can help reduce the risk of developing a vaginal fistula.
3. Getting regular check-ups: Getting regular check-ups with a healthcare provider can help identify any potential problems early on.

Complications

If left untreated, vaginal fistulas can lead to several complications, including:

1. Urinary incontinence: Women may experience urinary incontinence due to damage to the urinary tract.
2. Fecal incontinence: Women may experience fecal incontinence due to damage to the rectal tract.
3. Painful intercourse: Women may experience painful intercourse due to damage to the genital area.
4. Emotional distress: Women may experience emotional distress due to feelings of shame or embarrassment.

Diagnosis of Vaginal Fistula

The diagnosis and evaluation of a vaginal fistula typically involves a combination of physical examination, imaging tests, and laboratory tests. The following tests may be performed:

1. Physical examination: A physical examination will be performed to assess the size and location of the opening.
2. Imaging tests: Imaging tests such as ultrasound or CT scan may be performed to assess the extent of the damage.
3. Laboratory tests: Laboratory tests such as urinalysis or stool tests may be performed to determine if there is any infection present.

Treatment for Vaginal Fistula

The treatment and management of a vaginal fistula typically involve surgery followed by rehabilitation and physical therapy. The goal of surgery is to repair or close the abnormal opening and restore normal function.

When to seek medical attention ?

Women who are experiencing symptoms that are suspicious for a vaginal fistula should seek medical attention promptly. If you are experiencing any symptoms that are concerning you, it is always best to speak with your healthcare provider.