A vaginal fistula is an opening/hole that occurs between the vagina and another organ i.e. bladder, colon or rectum. This hole will allow urine, gas or stool to pass through to the vagina. A vaginal fistula can develop after childbirth, surgery, infection or radiation treatment.
There are many types of vaginal fistulas which are named after the location and the organs they affect:
- Between the vagina and bladder (vesicovaginal)
- Between the vagina and the tubes that carry urine from the kidneys to the bladder (ureterovaginal)
- Between the vagina and the tube that carries urine out of the body (urethrovaginal)
- Between the vagina and the rectum (rectovaginal)
- Between the vagina and the colon (colovaginal)
- Between the vagina and small intestine (enterovaginal)
The World Health Organisation reports that between 50,000 – 100,000 women develop vaginal fistulas every year. Unfortunately, vaginal fistulas are more common in countries where women have limited access to medical resources.
The cause of fistulas is a lack of blood supply to the tissue causing it to breakdown. In childbirth the pressure from the baby can limit the blood supply to the vaginal tissue. Other causes can be prolonged labour, tears or episiotomies, caesareans, cancers in the pelvic area or radiation.
How do you know if you have a fistula, you may be asking? Here’s a list of symptoms that people who have vaginal fistulas may experience.
- Constant urine leakage
- Chronic urine odour
- Skin irritation to the vagina, vulva or perineum
- Painful intercourse
- Recurrent UTI’s
- Abnormal discharge
If you think you may have a vaginal fistula it is important to make an appointment with your medical practitioner. The assessment will consist of a physical exam, imaging and urine analysis. Treatment includes antibiotics with management being different dependent on the location of the fistula. In most circumstances internal fistulas will need surgical repair however, some other fistulas may heal on their own.
Following fistula repair a 2019 study by the Physiotherapy Committee of the International Continence Society (ICS) reported that women would benefit from: pelvic floor muscle assessment, education and exercise from a physiotherapist. With further physiotherapy indicated for those who experience persistent dysfunction post closure of the fistula. Further evidence is required to determine the effectiveness of physiotherapy management; however, it was concluded by the ICS that patient outcomes were improved with the involvement of a physiotherapist. (Brook, G. 2019)
Bump Fitness has trained Women’s Health Physiotherapists that can assist you with your postnatal recovery. We are experienced in helping women with urge/stress incontinence, ab separation, returning to exercise post birth and many more pelvic conditions. Reach out today to get started!
Until next time,
Courtney
References
Cleveland clinic 2021 https://my.clevelandclinic.org/health/diseases/22079-vaginal-fistula
Brook, G & ICS Physiotherapy Committee. 2019. Obstetric fistula: The role of physiotherapy: A report from the Physiotherapy Committee of the International Continence Society https://pubmed.ncbi.nlm.nih.gov/30311690/