Vaginal Fistula

Vaginal fistula is an abnormal opening of the vagina which connects it with another organ such as urinary bladder, colon or rectum. This allows stool or urine to pass through vagina. Such disorder can develop as a result of an injury, surgery, infection or radiation treatment.

Several types of vaginal fistulas exist which include:

• Vesicovaginal fistula (opening between vagina and urinary bladder)
• Ureterovaginal fistula (opening between ureters and vagina)
• Rectovaginal fistula (opening between rectum and vagina)
• Urethrovaginal fistula (opening between urethra and vagina)
• Colovaginal fistula (opening between colon and vagina)
• Enterovaginal fistula (opening between small intestines and vagina).

Signs and symptoms of vaginal fistula include abnormal discharges of the vagina like feces, urine. There may be problems with sexual life also.

Vaginal Fistula cause by an injury, surgery, infections or radiation treatment.

To diagnose vaginal fistula, medical history will be important, assessment of possible risk factors such as pelvic surgery or pelvic radiation.

Doctor will start the diagnosis with pelvic examination and some of the following tests may be recommended:

• Dye test - doctor fills the bladder with a dyed solution and asks to cough, this will show the vaginal leakage with the dyed fluid.
• Cystoscopy - during this procedure, a hollow tube with a lens is inserted into the bladder and urethra for signs and symptoms.
• Retrograde pyelogram - in this test, doctor injects dye through urinary bladder into the ureter and then take X-ray.
• Fistulogram - it is an X- ray image of fistula.
• Flexible sigmoidoscopy - a sigmoidoscope (a thin, flexible tube with tiny video camera is inserted).
• Computerized tomography urogram - in this test, a dye is injected into the vein and a CT scan is taken.
• MRI - it uses magnetic field to create detailed images of the fistula.

Generally, conservative treatment for vaginal fistula is given. However, fistulas require surgery to be closed.

The following types of treatments are available:

• Conservative therapy - this kind of therapy allows the fistula to heal on its own. The doctor may recommend constant bladder drainage, placing a stent and taking fiber supplements.
• Surgery - surgery is required to close the abnormal opening using laparoscopic surgery or robotic surgery.

Proper hygienic conditions must be maintained to prevent the vaginal fistula.

No alternatives and home remedies exist to treat vaginal fistula.

There are several risks and complications associated with vaginal fistula.

The risk factors of developing vaginal fistulas include predispositions to infections, previous surgeries or radiation treatment for cancer.

Complications include the spreading of the infection from one organ to other. It may also lead to leakage of vaginal and urinary tract to the abdominal cavity and peritonitis may develop.