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Vaginal Fistula

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Introduction

A Vaginal Fistula is a severe medical condition that develops in a woman’s vagina. The doctor might describe the fistula as a tiny hole that allows stool or urine to pass through the vagina.

A Vaginal Fistula can be very upsetting. The leakage of stool and urine from the vagina can be embarrassing and smell bad.

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What is Vaginal Fistula?

A Vaginal Fistula is an abnormal and unusual opening that connects your vagina to other organs in your body, such as the bladder, rectum, or colon. These openings can develop due to certain surgeries, injuries, infection, or radiation treatments. You may have to undergo treatment options to get the opening closed to restore bowel movements.

There are different types of Vaginal Fistula, namely:

  • Vesicovaginal fistula: opening between the vagina and the bladder. It is also known as a bladder fistula and is the most common type of vaginal fistula.
  • Urethrovaginal fistula: opening between the vagina and the urethra (the thin tube that carries urine out of your body). It is also called the urethral fistula.
  • Rectovaginal fistula: opening between the vagina and the rectum (the lower part of the large intestine).
  • Ureterovaginal fistula: opening between the vagina and the ureters (ducts that carry urine from the kidneys to the bladder).
  • Colovaginal fistula: opening between the vagina and the colon.
  • Enterovaginal fistula: opening between the vagina and the small intestine.

What are the Causes of Vaginal Fistula?

In most cases, a Vaginal Fistula is caused due to tissue damage in the vagina. The following factors can cause tissue damage:

  • ● Abdominal surgery such as C-section or hysterectomy
  • ● Radiation treatment
  • ● Colon, pelvic, or cervical cancer
  • ● Childbirth
  • ● Bowel diseases such as diverticulitis or Crohn’s disease
  • ● Infection caused during childbirth or after an episiotomy
  • ● Traumatic injuries such as a car accident

What are the Symptoms of Vaginal Fistula?

Usually, a Vaginal Fistula does not cause any pain. However, it can cause problems that may require immediate medical care. If you develop a vesicovaginal fistula, the urine will leak from your bladder and into your vagina. It will make you unable to control your urination.

It may also make your genitals sore, which can cause difficulty during intercourse.

The common signs and symptoms of a Vaginal Fistula include:

  • ● Diarrhoea
  • ● Unexplained weight loss
  • ● Vomiting
  • ● Nausea
  • ● Stomach pain
  • ● Fever
  • ● Foul-smelling vaginal discharge
  • ● Recurrent vaginal infections
  • ● Irritation in the vulva or vagina

If you experience any of the symptoms mentioned above, immediately seek medical assistance.

How is Vaginal Fistula Diagnosed?

The doctor may ask you about your medical history to see if you have any risk factors for a Vaginal Fistula such as a vaginal infection, injury, or recent surgery.

To confirm the diagnosis, the following tests and examinations may be done:

  • Dye Test: For this test, the doctor will inject a blue dye into your bladder. A tampon will be inserted into your vagina. If the dye leaks out from your vagina, the tampon will turn blue. This will confirm the diagnosis of a vaginal fistula.
  • CT scan: A CT scan of the abdomen and pelvis can help locate the fistula and determine its causes.
  • Cystoscopy: Using a thin device known as a cystoscope, the doctor will look inside your bladder and urethra for damage.
  • X-rays: There are two common types of X-rays done to diagnose a Vaginal Fistula, namely:
  • Retrograde pyelogram: for this test, the doctor will inject a dye into your ureters through the bladder. An X-ray will be taken to see if there is leakage between the ureter and the vagina.
  • Fistulogram: this will create an X-ray image of your Vaginal Fistula. It will help the doctor determine if there is more than one fistula or other organs are damaged.

How is Vaginal Fistula Treated?

Some Vaginal Fistulas heal on their own. If you develop a small vaginal fistula, the doctor may insert a tiny tube known as a catheter into your bladder to drain the urine. This will also give the fistula time to heal on its own.

The doctor may devise a treatment plan for you based on the size, causes, and location of the fistula.

The treatment options include:

  • Medications: To help treat the Vaginal Fistula or prepare you for surgery, the doctor may recommend antibiotics. It will help treat infections surrounding the vaginal fistula. You may also be prescribed antibiotics such as infliximab if you develop a Vaginal Fistula because of Crohn’s disease.
  • Surgery: Severe cases of Vaginal Fistula may require surgery. For the surgery to be successful, the tissues surrounding the fistula need to be healthy. The doctor may recommend waiting for three to six months to let the tissue recover and see if the fistula heals on its own.

Surgical options include:

  • ● Sewing a patch of skin over the fistula to close it
  • ● Using a tissue graft from a healthy part of the body over the fistula opening
  • ● Fixing the muscles of the anus if they are damaged
  • ● Folding a skin flap over the fistula

What is the Results of Vaginal Fistula Treatment?

In most cases, surgery completely cures Vaginal Fistula. However, women with Crohn’s disease who develop a Vaginal Fistula are at an increased risk of complications such as fistulas that do not heal properly or fistulas that keep returning after surgery.

What are the Risk Associated with Vaginal Fistula Treatments?

Risks from Vaginal Fistula surgery are quite rare. However, some patients may experience the following risks:

  • ● Bleeding
  • ● Damage to the bowel
  • ● Nerve damage

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FAQ's

What Does a Vaginal Fistula Smell Like?

If you develop a Vaginal Fistula, you may experience a foul-smelling liquid or gas discharge from your vagina.

What Happens if a Vaginal Fistula is Left Untreated?

If left untreated, Vaginal Fistulas can cause severe discomfort and complications. Some fistulas may result in a bacterial infection which can even lead to sepsis.

What Does a Vaginal Fistula Look Like?

A Vaginal Fistula is an unusual, infected, tunnel-like passageway that develops between the vagina and other organs of the body. On the skin, the fistula may look like an open boil.

Can you Live with a Vaginal Fistula?

Vaginal Fistulas can cause severe discomfort. Fortunately, most cases of fistulas can be treated with surgery and provide the patients suffering from fistulas a long and healthy life.

Is a Vaginal Fistula Emergent?

Depending on the location and size of your fistula, the doctor may recommend a treatment plan. Most times, the doctor waits for a few months to let the surrounding tissue of the fistula heal on its own before performing the surgery.

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