A fistula is a passage or hole that has formed between:
A fistula that has formed in the wall of the vagina is called a
See pictures of a
vesicovaginal fistula and a
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.
A vaginal fistula is painless. But a fistula lets urine or feces
pass into your vagina. This is called incontinence. And it causes embarrassing
soiling problems that you cannot control.
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:
Your doctor may also use an X-ray or scope to get a clear look
and check for all possible tissue damage.
If you have a vaginal fistula, you will most likely need surgery
to repair it. Before surgery, your doctor will see whether the tissue is
healthy or needs to heal first.
After fistula repair surgery, be sure to follow your doctor’s
instructions. See your doctor right away if you have signs of infection, such
as a fever, tenderness, swelling, or redness.
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking.
Other Works Consulted
Katz VL (2007). Postoperative counseling and management. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 661–710. Philadelphia: Mosby Elsevier.
Lentz GM (2012). Anatomic defects of the abdominal wall and pelvic floor. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 453–474. Philadelphia: Mosby Elsevier.
Wong M, Ozel B (2010). Fistulae. In Management of Common Problems in Obstetrics and Gynecology, 5th ed., pp. 328–332. Chichester, UK: Wiley-Blackwell.
September 27, 2011
Sarah Marshall, MD - Family Medicine
& Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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