Intimate Wellness Institute

What is a Fistula?

A fistula is an abnormal, usually tubular, connection or passageway that forms between two body organs or between an organ and the skin. In women, fistulas can occur in various locations, but one of the most common types is obstetric fistula, which is a hole that develops between the vaginal wall and the bladder or rectum. Fistulas can have profound physical and emotional consequences for affected women.

Symptoms of Fistula

Fistulas in women can result in a range of distressing symptoms, including:

  • Urinary Incontinence: The most common symptom is uncontrollable leakage of urine, often leading to constant wetness and a foul odor.
  • Fecal Incontinence: In cases where the fistula involves the rectum, stool leakage and flatulence may occur.
  • Vaginal Discharge: Women with vaginal fistulas may experience continuous vaginal discharge, which can be unpleasant and irritating.
  • Recurrent Infections: Frequent urinary tract infections and other genital infections are common due to the constant exposure of the urinary or fecal system to bacteria.
  • Pain and Discomfort: Depending on the type and location of the fistula, women may experience pain or discomfort, particularly during sexual intercourse.
  • Emotional Distress: The physical symptoms of fistula often lead to emotional and psychological distress, including depression and social isolation.

Causes of Fistula in Women

The most common causes of fistula in women include:

  • Obstetric Fistula: Prolonged or obstructed labor during childbirth is a leading cause of obstetric fistulas. Pressure from the baby’s head can damage nearby tissues, leading to a hole between the vaginal wall and the bladder or rectum.
  • Surgical Complications: Fistulas can develop as a complication of gynecological, colorectal, or urological surgeries, especially if there is tissue damage or poor surgical technique.
  • Infection: In rare cases, severe infections or abscesses in the pelvic area can cause tissue breakdown and lead to fistula formation.
  • Inflammatory Conditions: Conditions like Crohn’s disease, ulcerative colitis, or diverticulitis can increase the risk of fistulas in the digestive tract.

Types of Fistula

There are several types of fistulas in women, depending on their location and origin. Common types include:

Vesicovaginal Fistula (VVF): This type of fistula connects the bladder to the vagina, resulting in urinary incontinence.

Rectovaginal Fistula (RVF): RVF involves an abnormal connection between the rectum and the vagina, leading to fecal incontinence and other symptoms.

Urethrovaginal Fistula: This type occurs between the urethra and the vagina, causing urinary leakage.

Treatments for Fistula

The treatment of fistula in women depends on various factors, including the type, location, and severity of the condition. Common treatment options include:

  • Surgery: Surgical repair is often necessary to close the fistula. Depending on the type and complexity, different surgical techniques may be used.
  • Medical Management: In some cases, particularly with small fistulas, medical management can be attempted to control symptoms and promote healing.
  • Physical Therapy: Pelvic floor physical therapy can help women regain control over their urinary and bowel functions and improve pelvic muscle strength.
  • Emotional Support: Counseling and emotional support are vital components of fistula treatment to help women cope with the physical and emotional consequences of the condition.
  • Prevention: Obstetric fistulas can be prevented through timely access to quality maternal healthcare, including skilled attendance during childbirth and access to emergency obstetric care.

Fistulas can have devastating effects on their physical and emotional well-being. Timely diagnosis, appropriate medical care, and support are essential in managing this condition and helping affected women regain their quality of life.