Vaginal fistula

Overview

Vaginal fistula occurs when the vagina and an organ in the urinary or digestive system has formed an unusual hole between them such as a vaginal fistula can connect the vagina to the bladder, urethra, or rectum. A hole develops because of damage or trauma to the tissue in the vaginal wall.

Vaginal fistula affects 50,000 to 100,000 women yearly around the world. It occurs from damages caused by childbirth, infection, chronic disease, radiation therapy, and surgery trauma. Doctors explain this condition as having a hole in the vagina that permits the stool, urine, or gas to pass through it.

The most common types of vaginal fistulas are:

• Vesicovaginal fistula: One of the most common types of fistula. The opening occurs between the bladder and vagina. Bladder is the organ that stores urine.
• Ureterovaginal fistula: The opening occurs between the vagina and the ureters.  Ureters are tubes that transports urine from the kidneys to the bladder.
• Urethrovaginal fistula (urethral fistula): The opening occurs between the vagina and the urethra.  Urethra is the tube that removes urine from the body.
• Rectovaginal fistula: The opening occurs between the vagina and the rectum. Rectum is the lower region of the large intestine that removes stool from the body through the anus.
• Colovaginal fistula: The opening occurs between the vagina and the colon.
• Enterovaginal fistula: The opening occurs between the vagina and the small intestine.

The fistula itself will not cause pain but the symptoms that can come with it may give discomfort. Some fistulas heal on its own, but most cases will require surgery to repair it.

Symptoms

The signs and symptoms depending on the organ the fistula has linked the vagina with such as in the urinary system or digestive system organs.

Vaginal fistula between the urinary organs may include the following symptoms:

• Sore and irritated vaginal area
• Urinary incontinence or leakage
• Chronic urine odor
• Pain during intercourse
• Recurrent urinary tract infections, vaginal infections, and kidney infections

Common symptoms of vaginal fistulas between the vagina and the digestive system are:

• Vaginal discharge with foul odor
• Abdominal pain
• Fecal leakage or incontinence
• Diarrhea
• Nausea and vomiting
• Painful intercourse
• Recurrent UTIs or kidney infections
• Rectal or vaginal bleeding
• Unexplained weight loss

Causes

A fistula occurs when the vaginal tissue in a specific area has damage or trauma therefore it is not receiving enough blood and eventually dies. Vaginal fistula may appear within a few days or years after the damage.

Commonly, a fistula may occur after:

• Long hours of labor during childbirth
• Episiotomy
• Abdominal or pelvic surgery
• Pelvic, cervical or colon cancer
• Traumatic injury from accidents
• Inflammatory bowel diseases (IBD) like Crohn’s diseases and ulcerative colitis
• Colon infections
• Radiation treatment

A vaginal fistula at birth is rare but possible.