Vaginal fistula is a hole between the vaginal wall and another organ, such as bladder, rectum or colon. It is one of the most degrading abnormalities because stool or urine pass through the vagina.
There are several types of vaginal fistulas, depending on which organ the vaginal wall is connected to. Therefore, there are:
- bladder fistula – it is an opening between the vagina and urinary bladder
- Ureterovaginal fistula – it is an opening between the vagina and the uretes (the tubes that carry urine from the kidneys to the bladder)
- Urethral fistula – it is an opening between the vagina and the urethre (the tube that carries urine outside your body)
- Rectovaginal fistula – it is an opening between the vagina and the rectum
- Colovaginal fistula – it is an opening between the vagina and the colon
- Enterovaginal fistula – it is an opening between the vagina and small intestine
Vaginal fistula is caused by injury, surgery or childbirth and therefore a general term is also used for all the types, obstetric fistula.
Most of the cases of vaginal fistula occur in developing countries. This is due to unrelieved obstructed labour during childbirth, early marriage (as custom in some countries) when young girls are not properly developed so that they can go through the delivery without complications.
The symptoms of vaginal fistula are:
- urine or stool pass through the vagina
- foul smell
- vaginal ifections
- urinary infections
- pain during intercourse
The causes of vaginal fistula are:
- injuries during delivery
- surgery of the vagina, rectum, anus or lower pelvic region
- cancer or radiation therapy in the pelvic region
- Crohn’s disease
The immediate complications of vaginal fistula are urinary incontinence and/or faecal incontinence. The other complications are:
- paralysis of parts of the lower half of the body if the nerves to the lower limbs are damaged
- birth to stillborn baby, after which the woman can be childless
Prevention of vaginal fistulas requires skilled attendants at birth and a swift surgical intervention if obstructed labour occurs.