Dye Test
Under the dry test diagnosis, the doctor will fill your bladder with a dye solution. The doctor will then ask you to cough, and if the dye appears through the vagina, it confirms the presence of a vaginal fistula.
Cystoscopy
The doctor uses a thin device with a camera at its end called a cystoscope to check inside your bladder and urethra for any damage.
X-rays
Retrograde Pyelogram
Under this technique, a dye is injected into the bladder and through x-ray, images have captured that show the possible leakage between a ureter and vagina in case of a fistula.
Fistulogram
This is an X-ray of the pelvic region to show one or multiple fistulas. This test also shows if any other pelvic organs are connected to the fistula.
Flexible Sigmoidoscopy
The doctor uses a thin wand-like tube with a video camera called a sigmoidoscope, to check the anus and the rectum region for fistula or damage.
CT Urogram
Under this technique, a dye is injected into the vein and CT scans take images of your vagina and urinary tract showing the possible leaks in case of a fistula
Pelvic MRI
Magnetic fields and radio waves are used to take detailed pictures of the patient's rectum and vagina to help show the details of a fistula.
Fistulas are majorly treated through surgery. However, surgery is not advisable if there is an infection or inflammation.
The doctor might recommend waiting for 3-6 months to check if the infection subsides through antibiotics and if the fistula self-heals.
Fistulas are usually treated through surgeries. The type of surgery is dependent on the type of fistula as well as location and intensity.
Laparoscopic surgery makes small incisions in the abdominal region to use cameras and operation tools for image-guided treatment.
This is an open surgery performed through the abdominal region.
This is robot-assisted laparoscopic surgery.
Vaginal fistulas that are connected to the rectum are treated in certain ways as below-
Sewing a patch over the fistula.
Closing the fistula by using tissue from another part of the body.
Putting a flap of healthy tissue over the fistula.
Fixing the anus muscles if they are damaged and have lost control.
While some vaginal fistulas heal on their own, others require critical care and treatment.
In the case of small bladder fistulas, the doctor might use a catheter to drain the urine while allowing the fistula to heal completely.
Alternately, the doctor might use a special glue to seal or fill the fistula. This special gel is made of natural proteins.
The doctor will also supplement the recovery and subside any infection by prescribing antibiotics.
• Conservative therapy
Conservative therapy is used in cases where the fistula is small, the patient does not have cancer, or the patient has not undergone radiation therapy.
In such cases, the conservative approach might help heal the fistula.
As per the therapy, the doctor might insert a catheter in the patient's bladder to drain it, therefore keeping the urinary tract clean and dry allowing the fistula to heal on its own.
Alternately a ureteral stent is used that is a small tube and holds the ureter open. The stent helps the urine flow from the kidneys to the bladder.
Injury to the pelvic region
An earlier surgery
An infection
Radiation treatment
Therefore, whatever could be the reason for the development of the fistula, it needs to be consulted and diagnosed by a doctor for a quick treatment.
A vaginal fistula is an internal and abnormal opening formed between the vagina as well as the bladder, colon, or rectum.
Doctors would indicate the condition to you like a hole in your vagina that allows stool or urine to pass unnaturally through the vagina.
Vaginal fistulas primarily need a lot of hygiene and care and conditions like-
• Regular intake of antibiotics or medications the doctor has prescribed.
• Maintain the area clean by washing the vagina gently with warm water, during stool or foul-smelling discharge.
Use mild and unscented soap and keep the area dry.
• Reduce irritation by applying talcum powder or a moisture-barrier cream to the vagina and rectum.
• Preferably wear loose and breathable clothing, made from cotton or other natural fabrics.
• Make use of disposable underwear or adult diapers to stay clean and hygienic.
Vaginal fistulas can be embarrassing to deal with when they involuntarily leak and produce a foul smell. But vaginal fistulas can also lead to complications like –
• Recurring vaginal or urinary tract infections.
• Hygiene problems.
• Vagina leaking stool or gas.
• Irritated or inflamed skin around the anus or vagina.
• Fistulas leading to an abscess (swollen clump of infected tissue with pus) that could be dangerous, if not treated.
• Recurring fistulas
There are high chances for women with Crohn's disease to develop fistulas or fistulas that do not heal.
Every surgery is risky to a certain extent. However, some of the risk factors associated with vaginal fistula surgery are-
• Bleeding
• Infection
• Blood clots in the legs or lungs
Damage to the bladder, ureters or bowel
• Blockage in bowel movement
• Scarring
The surgery process involves both a gynaecology surgeon and colorectal surgeon, depending on the type of fistula.
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