What are Fistulas?
A fistula is an abnormal connection through a tunnel-like hole within two glands or vessels. Fistulas can occur in several parts of the body. In women, most commonly fistulas involve the genital and urinary tracts and happen due to extended or blocked childbirth, injury during the pelvic surgery, infection, inflammation or radiation treatment in the pelvis and genital area.
The most common fistulae in women is that occurs between the bladder and vagina, which is known as a vesicovaginal fistula and also the one that occurs between the rectum and vagina known as a rectovaginal fistula.
- Vesicovaginal fistula generally associated with urinary incontinence or leakage of urine into the vagina, which is quite severe.
- Rectovaginal fistula can lead to faecal incontinence or leakage of faeces into the vagina.
Causes of Fistulas
The most common cause of fistulas is a link between the vagina and the bladder injury during the pelvic surgery, particularly hysterectomy. While the symptoms may occur immediately after the surgery, sometimes they can be delayed for1-2 weeks. Rectovaginal fistula befalls after childbirth connected with a massive vaginal tear. Urogenital and colorectal fistulas also generated by aborting, pelvic ruptures cancer or radiation treatment at the pelvic area; ulcer of the glands near the rectum, rabble-rousing bowel disease such as Crohn’s disorder and ulcerative colitis and infected episiotomies later childbirth.
Symptoms of Fistulas
A vesicovaginal fistula between the bladder and vagina will be painless but will cause troublesome lechery problems which will not be regulated as urine continuously dribbles into the vagina upon entering the bladder. The genital area may become sore or infected, and there may be pain during intercourse.
A woman with a rectovaginal fistula or a leak within the rectum and vagina may involve the way of foul-smelling gas, stool or pus from the vagina, also pain during the intercourse.
Some other symptoms of fistulas are:
- Frequent infections
- Abdominal pain
- Weight loss
Treatment options of Fistulas
By taking appropriate medical care, fistulas can be treatable and preventable. When you concern your private gynaecologist may ask for the symptoms and what may have caused them. The consultant gynaecologist may conduct physical exams to check for a urinary infection, conduct blood analyses and use a stain to find all spots of leakage. An x-ray or scope may also be done to obtain a bright look and check for all possible tissue damage. The fistulas will not be cured by their own. Some small vesicovaginal fistulas that are detected in the early stage may be healed by setting a catheter in the bladder for a specific time. Surgical repair is the treatment for most fistulas.
By minimally invasive vaginal approach, the vesicovaginal fistula can be repaired. In some situations, a minimally invasive laparoscopic or robotic or open surgical procedure may be considered.
During the surgery, the consultant gynaecologist will check the damaged area for cellulitis, oedema or infection, while eliminating any scar tissue, make sure blood supply is proper. Once the surgery was done, appropriate antibiotics or other medications may be suggested.
Women should never hesitate to visit the consultant gynaecologist if they experience fistulas. Struggling through symptoms is irrelevant – particularly with the wide variety of ways to diagnose and treat the conditions. To know what diagnosis is best for you, contact us to request an appointment with our private gynaecologist Mrs Sarah Hussain.