What are fistulas?
A fistula is an abnormal connection between a tunnel-like hole between two organs or vessels. Fistulas may occur in various parts of the body. In women, fistulas include the genital and urinary tracts are the most regular and happen because of prolonged or obstructed childbirth, injury during pelvic surgery, infection, inflammation or radiation treatment in the pelvis or genital area.
The most common fistulae in women are one that happens between the bladder and vagina.
Fistulas can involve other genital organs:
- Ureterovaginal fistulas
- Anal fistula
Causes of Fistulas
The common cause of a connection between the vagina and the bladder is the injury to the bladder during the pelvic surgery, especially hysterectomy. Symptoms may occur immediately after surgery. Sometimes it may delay for 1-2 weeks.
Symptoms of Fistulas
A vesicovaginal fistula or flow between the bladder and vagina can be painless; however, will cause troublesome incontinence problems that cannot be regulated as urine continuously dribbles into the vagina upon entering the bladder.
- Frequent infections
- Abdomina pain
- Weight loss
Treatment of fistulas
Taking proper medication makes fistulas both treatable and preventable. Your female gynaecologist will talk about the symptoms and what may have caused them. Your consultant may check for urinary tract infection, also conduct blood tests and use a dye to locate all areas of leakage. Fistulas will not be treated on their own. Small vesicovaginal fistulas that are detached early may be managed by placing a catheter in the bladder for some time. Most of the fistulas are treated surgically.
Most often, vesicovaginal fistula can be treated by a minimally invasive vaginal procedure. In some situations, a minimally invasive laparoscopic or robotic or open surgical approach may be preferred.
While doing surgery, the consultant will check the damaged area for cellulitis, oedema or infection, while also eliminating any scar tissue and securing proper blood supply. Once after surgery, antibiotics or other medications may be prescribed.