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Vaginal Fistula

vaginal fistula Disease and it's overview
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The organs in your body are made up of tissues, which are groups of multiple cells that come together to perform a function. The tissue walls of organs enclose them and prevent abnormal interchange with organs in different body systems like the digestive, reproductive, and urinary systems. 

A fistula is defined as an unusual opening that develops between two organs of the body. A vaginal fistula is a tunnel-like opening that develops in the vagina wall.

What is Vaginal fistula?

Your vagina is the muscular tube that runs from your vulva and connects to the mouth of your uterus. vaginal fistula opens between your vagina and another organ, such as the colon in your digestive system or the bladder in your urinary system. It is usually in the form of a hole caused by damage to tissue in the wall of the vagina.

The vaginal fistula can lead to an abnormal interchange of fluids, gases, and substances between organs of different systems and the vagina. It can cause urine, gas, or stools to enter the vagina.

Vaginal fistulas can also develop between the vagina and organs such as the ureters, small intestine, and rectum. For the different types of fistula, the definition of the type is based on the organs involved. For example, a vesicovaginal fistula is one of the common types of fistula that develops between the bladder and the vagina.

What are the symptoms of vaginal fistula?

The symptoms are different based on the type of vaginal fistula. It helps to understand the signs of a vaginal fistula so you can know if you need to get a check-up done.

Urogenital fistula

This type of fistula forms between the vagina and organs in your urinary system. Symptoms of urogenital fistula include:

  • Urinary incontinence (urine leaking involuntarily through the vagina) 
  • Frequent urinary tract infections (UTIs)
  • Pain in the vagina or bladder 
  • Skin irritation in the vaginal and vulval area
  • Vaginal fistula discharge with odour 

The most common type of urogenital fistula is a vesicovaginal fistula. It develops between the wall of the vagina and the bladder. This leads to urine leaking through the vagina and causes an odorous smell. Vesicovaginal fistulas usually occur due to a complication after surgery involving the bladder or vagina.

Intestinal-vaginal fistulas

These fistulas form between the vagina and organs in your digestive system. Symptoms of Intestinal-vaginal fistula include:

  • Passing gas involuntarily due to leakage of gas
  • Fecal incontinence (stool leakage)
  • Pain or discomfort in the abdomen
  • Vaginal fistula discharge with odour
  • Vaginal infections
  • Pain or irritation in the vulva and vagina

A common type of fistula between the vagina and the digestive system is a rectovaginal fistula. A rectovaginal fistula is an unusual opening between the rectum (the lowest part of the large intestine) and your vagina. It can cause bowel contents like gas and stool to leak into the vagina. 

A rectovaginal fistula forms as a result of:

  • Inflammatory bowel diseases like Crohn’s disease
  • Cancer or radiation treatment in the pelvic area
  • Surgery involving the vagina, rectum, or anus

Symptoms of a rectovaginal fistula include:

  • Leakage of gas, stool, or pus through the vagina
  • Odorous vaginal discharge
  • Recurrent vaginal infections or UTIs
  • Pain during sexual intercourse

What are the causes of vaginal fistula?

A fistula in women is usually caused by tissue damage or inflammation. Traumatic vaginal fistulas occur due to damage to the tissue walls of the intestine, the urinary tract, or the vagina. This can happen due to surgical procedures/operations or prolonged labor during childbirth.

An inflammatory fistula in women can form due to abscesses or cysts in the vagina or other traumas arising from disease or infection such as a tumor disease or inflammatory bowel disease like Crohn’s disease.

A genital fistula can form when there is the insufficient blood supply to the vaginal tissue, causing tissues to die. Over time, this causes a hole to form in the tissue. Albeit rarely, sometimes a person can be born with a congenital vaginal fistula.

Diagnosis of vaginal fistula

During of vaginal fistula, the doctor will consider your symptoms and conduct a physical exam. The doctor will also recommend certain tests such as:

  • An ultrasound, CT scan, or MRI
  • A colonoscopy to examine the large intestine
  • A urogram (a CT scan of the vagina and urinary tract)

What are the treatments for vaginal fistula?

Treatment differs based on the types of fistula. Certain fistulas, such as those caused by infection, heal with medicines like antibiotics. A fistula caused by inflammation may heal with medication for the inflammation.

Courses of treatment may involve gastroenterology (treatment directed towards the digestive system), colorectal surgery (surgery involving the large intestine or the rectal tract), and urology surgery (involving the urinary tract). The hole caused by the vaginal fistula is covered with tissue or a special surgical material.

What are the complications of vaginal fistula?

Fistulas can cause various complications, such as urinary and faucal leakage, kidney and vaginal infections, pain during sexual activity, and abdominal discomfort.

Risk factors of vaginal fistula

Childbirth and certain surgery can result in a fistula in women. It can also result from a complication arising out of cancer or a pelvic injury.

Conclusion

Vaginal fistulas are caused by tissue damage to the vaginal walls. The kind of vaginal fistula depends on the organs involved. The treatment may involve surgery of the affected organs. You may also be prescribed medications or system-focused treatment based on what is causing the tissue damage. To get the best treatment for vaginal fistulas, visit the CK Birla Hospital or book an appointment with Dr. Astha Dayal.


FAQs

Ques 1. Can vaginal fistula heal on its own?

Yes, certain fistulas can heal on their own if the inflammation subsides or the infection resolves. However, this usually takes place with the help of medication to treat the infection or the cause of the inflammation or tissue damage. For a vaginal fistula, treatment will usually depend on the cause and nature of the fistula. 

Ques 2. How do you check for vaginal fistula?

You can visit a clinic, and the doctor will conduct a physical exam, which would usually include a pelvic exam for a genital fistula. The doctor will also use scans like an MRI scan, CT scan, or ultrasound to check the tissue involved.

Ques 3. How painful is vaginal fistula surgery?

Vaginal fistula surgery is performed under anesthesia. You may experience some pain and discomfort after surgery, and the wound takes some weeks to heal. 

Ques 4. How can we prevent a fistula?/How can I prevent getting a fistula?

You can prevent a fistula by maintaining a healthy diet to promote healthy tissue. You can also maintain good hygiene to avoid the development of infections. To avoid a genital fistula, maintaining healthy sexual habits and genital hygiene are important. 

Ques 5. What causes a fistula in females?

Fistula in women is usually caused by tissue damage that leads to the development of a rupture in the tissue that makes up an organ. This can be due to a surgical procedure, prolonged labour during childbirth, an accident or traumatic injury, or damage caused by inflammation or infection.

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