What are Fistula?

A fistula is an abnormal connection between two organs or parts of the body that should not be connected. Think of it like a tiny, unwanted tunnel that forms where it doesn't belong. While fistulas can happen in many places, they are most common in women within the urinary and vaginal systems. These tunnels can be caused by infections, inflammation, injuries from surgery, radiation therapy, or difficult and long childbirth.

What are the different types of fistulas?

The most common types in women involve the vagina, bladder, and rectum. A Vesicovaginal Fistula is a hole between the bladder and the vagina that usually causes urine to leak into the vagina. A Rectovaginal Fistula is a hole between the rectum and the vagina that can cause stool or gas to leak into the vagina.

Other types of fistulas can affect different organs:

• Cervical refers to an abnormal hole in the neck of the uterus (cervix).
• Enterovaginal is a tunnel between the small intestine and the vagina.
• Metroperitoneal is a connection between the uterus and the abdominal cavity.
• Recto-uterine is a connection between the uterus and the colon.
• Vesico-uterine is a connection between the bladder and the uterus.
• Ureterovaginal is a connection between the tubes that carry urine (ureters) and the vagina.

Anal Fistula is a small tunnel that connects the inside of the anus to an opening on the skin nearby.

Which factors lead to fistulas?

The most frequent cause of a connection between the bladder and vagina is an injury during pelvic surgery, such as a hysterectomy. Symptoms might show up immediately or take a week or two to appear. A deep tear during childbirth can also lead to a rectovaginal fistula.

In developing countries, the most common cause is prolonged labor. According to the World Health Organization, more than 2 million women worldwide live with this condition. It happens when labor lasts for several days and the baby’s head presses so hard against the birth canal that it cuts off blood flow. This causes the tissue to die and rot away, leaving a hole.

Other causes include pelvic cancer or radiation treatment, inflammatory bowel diseases like Crohn’s disease or ulcerative colitis, and infections after a surgical cut made during birth (episiotomy). Pelvic fractures, complications from abortions, and cases of sexual abuse or rape may also have a role.

What signs of fistulas are present?

The most obvious sign is leaking fluid from the vagina that you cannot control. If it is a bladder fistula, you will have a constant dribble of urine. While it may not be painful, it causes significant hygiene and skin issues. If it is a rectal fistula, you may notice foul-smelling gas, stool, or pus coming from the vagina.

Other common symptoms include pain during sexual intercourse, irritated or infected skin in the genital area, and frequent urinary tract or vaginal infections. Some women also experience nausea, vomiting, diarrhea, stomach pain, fever, and unexplained weight loss.

Which variables increase the likelihood of vaginal fistulas?

One of the direct causes of a vaginal fistula, such as childbirth, infection, surgery, or any of the medical conditions mentioned above, increases your likelihood of getting one.

What side effects might vaginal fistulas cause?

Dealing with a fistula can be emotionally and physically taxing. The constant leaking can lead to embarrassment or social withdrawal if you experience accidents in public. Other possible issues include recurrent renal, vaginal, or urinary tract infections. There is also a risk of narrowing of the vagina or rectum (stenosis) and the possibility of the fistula returning after treatment.

If a vaginal fistula ruptures, what would happen?

A vaginal fistula is not like a sac filled with fluid, so it cannot rupture or burst. It is simply an abnormal opening that allows urine and feces to flow freely. The flow is not trapped in a way that would cause it to burst.

How is the diagnosis of a vaginal fistula made?

Along with evaluating your symptoms, your doctor will conduct a physical examination, which will include a pelvic exam. To help you the best, let your doctor know about all of your symptoms. In certain cases, a pelvic exam is enough to identify a fistula, but in other cases, more tests will be ordered.

Tests used to diagnose vaginal fistulas include urinalysis and blood counts to check for infections. A dye test involves putting dye in the rectum or bladder to look for signs of vaginal leaks. A fistulogram X-ray helps find the size and quantity of fistulas. Doctors may also use a CT urogram or pelvic MRI to see the urinary system and rectum clearly. Other tests include a cystoscopy to see inside the bladder, a sigmoidoscopy or colonoscopy to look at the intestines, and a retrograde pyelogram to detect leaks between the ureters and vagina.

What options are there for treating fistulas?

The good news is that fistulas can be treated and often prevented with proper medical care.

When you see a doctor, they will want to discuss your medical history and symptoms. They may perform a physical exam, use a special dye to find the leak, or use blood tests to check for infection. To obtain a clear view, X-rays or small cameras (scopes) may also be used to look for potential tissue damage.

In most cases, fistulas do not heal on their own. Small fistulas found very early might be managed by using a catheter to drain the bladder for a while, but the standard treatment for the majority of cases is surgery.

The surgeon will remove any scar tissue and close the hole. This can often be done through a minimally invasive procedure through the vagina. In other cases, a doctor might use robotic surgery or a small incision in the abdomen (laparoscopy). After surgery, antibiotics or other drugs may be recommended to prevent infection.

How do women who have vaginal fistulas fare?

Vaginal fistulas can be successfully treated with surgery. The majority of women fully recover and lose their symptoms. After therapy, some fistulas may return or fail to heal adequately, especially if you have Crohn's disease or cancer. Untreated symptoms might also cause anxiety or depression.

Can a vaginal fistula be avoided?

It is typically impossible to avoid developing a vaginal fistula entirely, but you can try to manage the things that lead to them. For instance, you can handle long-term ailments like ulcerative colitis or Crohn's disease and treat pelvic infections as soon as possible. Getting regular prenatal care can help your doctor identify issues that could cause your labor and delivery to go longer. You can also select a surgeon with a lot of experience performing procedures like hysterectomies.

When should I get in touch with my doctor?

If you observe any signs of a vaginal fistula, get in touch with a doctor. These signs include leaking urine or feces from your vagina, discomfort during intercourse, or symptoms like fever, diarrhea, nausea, and abdominal pain.

What should I inquire about with my provider?

You might wish to ask your doctor what led to the fistula, what specific type you have, and how you should take care of yourself while you have it. You should also ask about your treatment options, potential surgical complications, and if there is anything you can do to avoid developing another one.

Why choose Tender Palm Super-Speciality Hospital for Fistulas treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Fistulas treatment in Lucknow, India. We have a team of experienced surgeons, gynecologists, and colorectal specialists. We provide accurate diagnosis through detailed evaluation and imaging, along with personalized medical and surgical treatment based on the type and location of the fistula. Our care focuses on infection control, safe fistula repair, prevention of recurrence, and faster healing. Our team works together to restore normal function and improve quality of life with complete and compassionate care.

To seek an Expert Consultation for Vaginal Fistula treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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