A vaginal fistula is an irregular opening in the vagina that connects to another organ, such as your bladder, colon, urethra, or rectum. Although they usually aren’t painful, most vaginal fistula symptoms are unpleasant and may not go away on their own. NewYork-Presbyterian understands the importance of treating vaginal fistulas with the utmost sensitivity and provides top-notch surgical and non-surgical treatment options.
Diagnosing Fistulas
DiagnosisDiagnosing a vaginal fistula requires a physical examination, including a pelvic exam, blood work, and other tests. Your doctor will inquire about your health history to determine if you are at risk for fistulas. Risks include recent births, infections, surgeries, or pelvic radiation treatments.
They may perform one or more of the following tests before delivering a fistula diagnosis:
- Cystoscopy - A device called a cystoscope is used to look inside your urethra and bladder for signs of tissue damage
- Dye test - Dye is injected into your vagina, bladder, or rectum to check for signs of leakage
- Urinalysis and blood test – These tests check for signs of infections
- Fistulogram X-ray – Helps locate fistulas and determine how many there are and the size
- Computerized tomography (CT) urogram - An imaging exam to check out the urinary system
- Pelvic MRI – Helps your physician see inside your rectum and vagina
- Flexible sigmoidoscopy – Allows doctors to see inside the rectum and the colon/lower large intestine
- Colonoscopy – Used to look inside your entire large intestine and your rectum
Treatment Options for Vaginal Fistula
TreatmentsFistula treatment options often depend on the type of fistula and its size. Some small fistulas may be able to heal with the help of conservative medical treatments, including:
- Antibiotics to treat infections
- Self-catheterization (temporary) to help empty your bladder while a vaginal fistula heals
- Ureteral/kidney stents to clear the ureters while a ureterovaginal fistula heals
Most vaginal fistulas require surgery in order to repair the irregular opening. The majority of these surgeries have positive outcomes.
Fistula surgery
In order to close the abnormal opening, fistula surgery may be the only course of action. Your doctor will determine which type of surgery is best based on the type of fistula and your symptoms. A surgeon may use tissue from your own body, surgical mesh, or synthetic tissue to close up the opening.
The location of your fistula will determine whether your surgeon will operate through your abdomen or vagina. Two popular methods of surgery include:
- Laparoscopic surgery - Using a small, telescopic camera that allows for a magnified view of your internal organs
- Abdominal surgery – Using a scalpel to make an incision in the stomach
For rectovaginal vaginal fistulas, where the opening connects to the rectum, your doctor may take one of the following approaches:
- Sew a synthetic patch over the fistula
- Take tissue from another area of your body to close up the opening
- Fold healthy tissue next to the fistula over the opening
- Repair the anal muscles if damaged
Surgical procedures for vaginal fistulas have a high success rate. The majority of patients make a full recovery and find relief from symptoms.
Vaginal Fistula Treatment Options at NewYork-Presbyterian
Here at NewYork-Presbyterian, we know how distressing vaginal fistulas and other pelvic floor issues can be. Our Columbia and Weill Cornell physicians are experts in urogynecology and take a multidisciplinary, individualized approach to fistula care. Make an appointment at one of our convenient locations today.