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What Is a Vaginal Fistula?

A vaginal fistula is a hole in the wall of the vagina.
The female reproductive system, including the vagina.
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  • Written By: J.L. Drede
  • Edited By: Jacob Harkins
  • Last Modified Date: 09 March 2014
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A vaginal fistula is a hole in the wall of the vagina. These holes usually create a passage to another part of the body, such as the bowels, colon or urinary tract. There are four kinds of vaginal fistulas: vesicovaginal, colovaginal, rectovaginal and enterovaginal. While they are usually painless, they can cause embarrassing and potentially dangerous side effects, in some cases.

The difference between the four types of fistulas is based on location of the hole between another body part and the vagina — vesicovaginal (urinary tract), colovaginal (colon), rectovaginal (rectum), and enterovaginal (small bowel). All are caused by tissue damage and do not happen spontaneously. Common causes include inflammatory bowel disease, radiation treatment for cancer, pelvic surgery, or an injury related from a problematic childbirth. The hole may not manifest itself for days or even years after the original damage to the tissue.

All kinds of fistulas cause vaginal irritation, and all but rectovaginal fistulas cause urinary incontinence, watery vaginal discharge, and a leakage of urine through the vagina. Since rectovaginal fistulas are holes between the vagina and the rectum, its most common symptoms are fecal incontinence and feces leaking into the vagina.

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When symptoms present themselves, a medical professional will conduct several tests to discover the nature of the fistula. A dye test is frequently given first. In this test, the bladder is filled with a dyed solution. The patient then passes the fluid while the healthcare professional examines the vagina, looking for leakage. This test can usually detect the location of the fistula. The medical professional will also usually use various scopes to inspect the vagina, ureters, bladder, anus and rectum. X-rays may also be taken to see if multiple fistulas are present.

Once a vaginal fistula diagnosis has been made, treatment can begin. In almost all cases, surgery is required to repair the damage. In the case of severe damage or dead tissue, the surgeon may introduce new tissue to help aide the recovery. More complicated procedures may be needed if the fistula was caused by a bowel diseases such as Crohn's. In these cases, a partial proctectomy — a surgical removal of a portion of the rectum — may be needed to prevent further complications. Additional treatment to help prevent further fistulas and help promote healing can include changes in diet and the addition of fiber supplements to improve bowel regularity.

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Discuss this Article

anon347428
Post 4

I had a hysterectomy 25 years ago and have had no problems with my bladder. That is, until I fell and injured my hip and groin areas. Since then, I have leakage and feel the passing of air through my urethra and pelvic pain.

I have seen a hip surgeon who said it was my back, so I saw my back surgeon and he said it was my hip. So I went back to the hip surgeon who said it was my back so I again went to see my back surgeon. I saw a third surgeon who was upset that the other two doctors claimed it was my hip or back and this third one said that it was my hip *and* my back, but not one of the three has given me any advice on who to see. Now I am finding this can be a serious problem.

About 90 percent of my day is consumed with thinking about the leakage and pain. Are doctors just shining me on because I am on Medicare and our state's health plan and they only get reimbursed about $280 on a $1,200 medical bill? I need help. I do not want to live this way and will not live the rest of my life like this.

Sierra02
Post 3

My mother's sister developed pelvic complications after a partial hysterectomy about six months ago. She had what they called a vesicovaginal fistula that had something to do with a uterine prolapse.

It wasn't until about three weeks ago before she said anything to her gynecologist about the problems she was having with vaginal discharge and urinary incontinence.

After a few tests they discovered it was a vaginal bladder fistula and now she is scheduled for surgery next week.

ellafarris
Post 2

@babylove - Recto-Vaginal fistual really does exist but the good news is, is that it's not that common to acquire one from childbirth, even for those who have had an episiotomy.

That's not to say however that it could not happen because it does. If your gynecologist does the repair correctly, there should be no cause for concern.

If, on the other hand you start experiencing rectal vaginal fistula symptoms you should see your physician right away. A reconstructive surgery called sphincteroplasty should be performed by a urogynecologist, rather than your OB-GYN.

Don't worry though your baby doesn't need you to stress over something that has no certainty to it. I'm sure everything is going to be just fine and congratulations!

babylove
Post 1

Hi. I'm twenty-four years old and almost eighteen weeks pregnant with my first child. A co-worker of mine told me this horrific story about her relative who developed rectovaginal fistula after childbirth.

Apparently she had an episiotomy during labor that wasn't repaired properly and now she lives with rectal gas and feces discharging from her vagina.

I couldn't believe it and I didn't believe it for awhile until curiosity got the best of me and I ran across this article. I''m really frightened now. I'm a small woman and the chances of me getting an episiotomy during labor are probably very high.

Is recto vaginal fistula that common after a vaginal delivery?

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