Urinary Fistula: Causes, Symptoms, Vesicovaginal Fistula

Urinary fistulas are irregular openings in the urinary tract that permit urine or feces to pass where they ordinarily wouldn't. They may also result from atypical connections between the organs of the urinary tract.

Urinary fistulas can take many different forms, including:

• Openings between the vagina and the bladder, known as vesicovaginal fistulas, are the most prevalent form of urinary fistula.
• Openings between the bladder and bowel are known as enterovesical fistulas.
• Openings between the bladder and uterus are called vesicouterine fistulas.
• Openings between the vagina and ureter ducts are known as ureterovaginal fistulas.

The disorder is more frequent in girls, but it can also happen in males as a side effect of hypospadias or other conditions.

Read this blog further to get a quick overview of this important topic for obstetrics and gynecology and ace your NEET PG exam preparation.

Causes of Urinary Fistula

Some of the causes of urinary fistula are mentioned below:

• Medical procedures like radiation and surgery
• Viruses (less frequent)
• The most common causes of vesicovaginal fistulas are hysterectomies and cesarean sections.
• Cancers like colon and cervical cancer
• Diverticulitis or inflammatory bowel disease 

Symptoms of Urinary Fistula

Because few females who have urinary fistulas complain of pain, urinary fistulas are typically identified through symptoms like:

• Fluids pouring from the vagina, including urine
• Leaking feces into the vagina
• Persistent urinary tract infections (UTIs) frequently
• Urethral gas expulsion during urination
• Abdominal discomfort

Vesicovaginal Fistula

An opening that forms between the bladder and the vaginal wall is known as a vesicovaginal fistula. As a result, pee occasionally softly leaks out of the vagina, but if the fistula is wide, it may be steady. This illness is immensely distressing in addition to being a major medical issue. Both the leaks and the odor are embarrassing.

Causes of Vesicovaginal Fistula

Vesicovaginal fistulas are frequently a side effect of surgery to treat bladder or vaginal issues. They can also be connected to gynecological cancer, either directly from the illness or occasionally as a result of radiation therapy or surgical procedures used to treat the malignancy. Fistulas can occasionally develop as a result of particularly severe or recurrent urinary tract infections, but this is uncommon.

The majority of vesicovaginal fistulas form shortly after surgery, and patients typically complain of significant new urine leakage.

Diagnosis of Vesicovaginal Fistula

To find out more, your doctor will often perform a thorough physical examination of the area. Imaging tests might be prescribed based on their findings. The most frequent diagnostics include pelvic X-rays and computed tomography (CT) scans, which use dye (also known as contrast) to highlight the tissues in that area of the body and make it simpler to pinpoint the problem's origin. Your vein or a catheter placed in your bladder is used to administer the dye. Additionally, your doctor will most likely use a scope to examine the bladder.

Treatment of Vesicovaginal Fistula

Vesicovaginal fistulas can only be treated surgically by blocking the entrance. When bladder injury is the root of the issue, extra operations may be required to address it.

Vesicovaginal fistula surgery typically has excellent results. However, the prognosis for women who develop a fistula as a result of a condition like cancer may be less favorable.

While the surgical region heals, the majority of women will require a catheter in the bladder for a few weeks.

Diagnosis of Urinary Fistula

A doctor's examination and discussion of the patient's medical history are the first steps in diagnosing a urinary fistula. The doctor might then advise more tests, like:

• A urine sample that will reveal any infections or other urinary tract issues
• (MRI) Magnetic resonance imaging
• A cystogram, which involves injecting dye into the bladder to help locate the source of the urine leak
• A fistulogram uses X-ray imaging to determine whether a fistula is present and which organs it is affecting

Also Read: Vaginal Yeast Infections

Treatment of Urinary Fistula

Conservative therapy and surgery are also available as treatment options. When the urinary fistula is minor, conservative therapy may be successful.

A doctor's examination and discussion of the patient's medical history are the first steps in diagnosing a urinary fistula. The doctor might then advise more tests like Larger urinary fistulas frequently necessitate surgery, which is normally carried out through the abdomen or the vagina.

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