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Vaginal Fistula - Topic Overview

What is a vaginal fistula?

A fistula is a passage or hole that has formed between:

  • Two organs in your body.
  • An organ in your body and your skin.

A fistula that has formed in the wall of the vagina is called a vaginal fistula.

  • A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula.
  • A vaginal fistula that opens into the rectum is called a rectovaginal fistula.
  • A vaginal fistula that opens into the colon is called a colovaginal fistula.
  • A vaginal fistula that opens into the small bowel is called a enterovaginal fistula.

See pictures of a vesicovaginal fistula camera.gif and a rectovaginal fistula camera.gif.

What causes a vaginal fistula?

A vaginal fistula starts with some kind of tissue damage. After days to years of tissue breakdown, a fistula opens up.

Vaginal fistulas are not a common problem in developed countries. But a fistula does sometimes happen after:

In developing countries where women have no health care nearby, vaginal fistulas are much more common. After days of pushing a baby that does not fit through the birth canal, very young mothers can have severe vaginal, bladder, or rectal damage, sometimes causing fistulas.

What are the symptoms?

A vaginal fistula is painless. But a fistula lets urine or feces pass into your vagina. This is called incontinence. And it can cause soiling problems that you cannot control.

  • If you have a vesicovaginal fistula, you most likely have fluid leaking or flowing out of your vagina.
  • If you have a rectovaginal, colovaginal, or enterovaginal fistula, you most likely have foul-smelling discharge or gas coming from your vagina.
  • Your genital area may get infected or sore.

How is a vaginal fistula diagnosed?

Your symptoms are the most clear signs of a vaginal fistula. Your doctor will want to talk about your symptoms and about any surgery, trauma, or disease that could have caused a fistula. For a physical exam, your doctor will use a speculum to look at the vaginal walls. You may have other tests, such as:

  • The use of dye in the vagina (and maybe the bladder or rectum) to find all signs of leakage.
  • Urinalysis to check for infection.
  • Blood test (complete blood count) to check for signs of infection in your body.

Your doctor may also use an X-ray, endoscope or MRI to get a clear look and check for all possible tissue damage.

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