A urogenital fistula, also known as a vaginal fistula, is a passage or a hole that has formed between two organs in your body, or a hole that between an organ in your body and your skin. A fistula that has formed in the wall of your vagina is called a vagina fistula. There a several different types of vaginal fistula:
- Vesicovaginal Fistula: a vaginal fistula that has opened into the urinary tract.
- Rectovaginal Fistula: a vaginal fistula that opens into your rectum.
- Colovaginal Fistula: a vaginal fistula that opens into your colon.
- Enterovaginal Fistula: a vaginal fistula that opens into your small intestine.
Causes of Vaginal Fistula
A vaginal fistula starts with tissue damage. After years (or in some cases days) of tissue breakdown, a fistula opens up. Vaginal fistulas are not a common problem in most developed countries. However, they can occur after several events. If you have had surgery on the back wall of your vagina, perineum, anus, or rectum you may develop fistulas. Open hysterectomy is linked to most vesicovaginal fistula cases. Radiation treatment for pelvic cancer can lead to vaginal fistulas. Diseases and conditions of the colon and small intestine. Crohn’s disease and ulcerative colitis are the principal types of inflammatory bowel disease.
Vaginal fistulas are more common in developing countries where women have no health care close to their home. This makes childbirth even more complicated and dangerous. After days of trying to push out a baby that does not fit through their birth canal, young mothers can have severe vaginal, bladder, or rectal damage, which sometimes causes fistulas.
Symptoms & Diagnosis
Vaginal fistulas are painless. But they can let feces or urine pass into your vagina, and your genital area may become infected or sore. Incontinence can occur, along with problems soiling yourself that you can’t control. The type of fistula you have will dictate what kind of leakage you have:
Vesicovaginal Fistula: Fluid will leak or flow out of your vagina
Rectovaginal or Colovaginal or Enterovaginal Fistula: You will have a foul-smelling discharge or gas coming from your vagina.
Symptoms are the clearest signs of a vaginal fistula. Your doctor will ask you about your symptoms and how long they have been going on. He or she will also ask about any surgery, trauma, or diseases that cause fistulas. Physical exam involves the use of a speculum to look at your vaginal walls. Other tests involving dye in your vagina, bladder, or rectum may be used to find all signs of leakage. Analyzing a urine sample to check for infection. A complete blood count is used to check for signs of infection in your body. Your doctor may use an X-ray, endoscope, or MRI to get a good look at your pelvic area and check for tissue damage.
Treating Vaginal Fistula
If you have a vaginal fistula, you will need surgery to repair it. You will also need tissue-healing medications and a diet that causes minimal strain during your bowel movements. Probiotic supplementation and emotional healing techniques are also vital to reduce stress and control the bacteria present in your body.
Your doctor will need to prepare you for your surgery in different ways depending on your condition. Before you get surgery, your doctor will need to make sure that your tissue is healthy. Your tissue may need to heal first. You will have medicine or wound care to heal these tissues before surgery. If you have a large rectovaginal fistula, you may need a colostomy before surgery to keep the fistula clear. After the repair heals your colostomy is taken out. If you have inflammatory bowel disease, your doctor will not do your surgery during a flare in your symptoms.
After the vaginal fistula repair surgery is done, make sure you are following any of your doctor’s recovery instructions. Call and visit your doctor immediately if you have any signs of infection. If your wound is infected, you need to get it treated immediately to allow yourself to recover from surgery. Contact your physician if you experience these signs of infection and inflammation:
Having a vaginal fistula can be surreal and frightening. It is important to remember not to panic and to seek the proper treatment. Your doctor will help you decide the best course of treatment for you.
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