A vaginal fistula is land unusual opening that develops between the vagina and another organ, such as the bladder, colon or rectum. In females, fistula involves the genital and surrounding organs.

Types of vaginal fistula

The types of vagina fistula is listed below

  1. Vesicovaginal fistula: A vesicovaginal fistula is an abnormal opening that develops between the bladder and the wall of the vagina. This result in urine leaking out of the vagina, sometimes lightly and steady if the fistula is large.



  1. Ureterovagina fistula: This type of fistula happens when an unusual opening develops between the vagina and the tubes that carry urine from the kidneys to the bladder

  1. Urethrovaginal fistula: this is the abnormal communication between the vagina and the tube that carry urine out of the body.

Representative illustration of urethrovaginal fistula.



  1. Rectovaginal fistula: A rectovaginal fistula is an abnormal connection between the lower portion of the large intestine, rectum and the vagina

Rectovaginal Fistula Treatment | Mercy St. Louis




  1. Colovaginal fistula: this is type of fistula that occur between the vagina and the large intestine

  1. Enterovaginal fistula: this is abnormal connection between the vagina and rectum

Causes of vaginal fistula

  • Prolong labor
  • Obstructed child birth
  • Injury during pelvis surgery such as cesarean section
  • Infection of genital area
  • Inflammation of genital area
  • Foreign bodies in the vagina
  • Chronic illness like diverticulitis

Symptoms of vagina fistula

There is no experience of pain or discomfort. However, symptoms which includes the following;

  • Urinary incontinence or leakage
  • Fecal leakage or incontinence
  • No urge to empty the bladder or bowels
  • Vaginal discharge, usually with a foul odor
  • Sore, irritated, or infected vaginal area
  • Abdominal pain
  • Recurrent urinary tract infections,  kidney infections and vagina infections
  • Painful intercourse
  • Nausea and vomiting
  • Diarrhea
  • Unexplained weight loss
  • Rectal or vaginal bleeding


Diagnosis of vagina fistula

Investigating vagina fistula for proper diagnosis includes:

  1. Medical history: past medical, surgical, family history is taken by health care provider to identify the possible causes such as recent pelvic surgery, childbirth, radiation therapy in the pelvic area.
  2. Physical examination: This will include a speculum examination and potentially a rectal examination. They may include additional imaging tests to rule out other conditions and confirm the presence of a vaginal fistula.
  3. Cystoscopy: This is the type of examination that helps  to visualize the inside of the bladder
  4. CT scan
  5. Dye test: This procedure involves the insertion of dye into the bladder to help identify leakage.

Treatment of vagina fistula

Treatment of vagina fistula depends on the type and location. Some small vaginal fistulas may heal without treatment, while severe conditions will require surgery. Surgical approaches are used depending on the fistula’s severity, complexity, and recurrence.

Some of the surgery used is

  • Laparatomy
  • Incision to either the vagina or the abdomen.


Procedure for surgical treatment of vagina fistula

  • General anesthetic is administered.
  • Cystoscope is used to visualize the inner part of the urethra and bladder.
  • A plastic tube is passed into the ureters to prevent damage during the procedure.
  • Incision is done inside the vagina or in the lower abdomen.
  • The bladder is separated from the vagina and repairs the fistula using dissolvable stitches.
  • Part of the fistula repair will involve removal of the fistulous tract.
  • The fatty tissue from the labia or abdomen is reinforced to the area.
  • Catheter is placed into the bladder through the urethra to allow the bladder to heal.

Complications of vagina fistula

Complication of vagina fistula includes:

  • Infections
  • Injury
  • Bleeding
  • Thromboembolism
  • Sexual dysfunction
  • Sexual dissatisfaction
  • Onset incontinence
  • Pelvic and abdominal adhesions
  • Pain during sex

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