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Fistulas

A fistula is an abnormal connection between two organs that normally do not connect. There are many types of fistulas – some of the more common include:

VESICOVAGINAL fistula: connection between the bladder and the vagina. This results in a continuous uncontrollable drainage of urine from the bladder into the vagina. They typically occur after pelvic surgery (hysterectomy), childbirth, and radiation exposure.

RECTOVAGINAL fistula: connection between the rectum and the vagina. This results in the passage of gas and possibly stools from the rectum into the vagina. This may occur after childbirth and may be associated with certain diseases of the gastrointestinal tract.

URETHROVAGINAL fistula: Connection between the urethra and vagina. This results in drainage of urine from the urethra into the vagina and result in leakage of urine from the vagina when one stands up after urination or splaying of the urinary stream. This may occur due to trauma, childbirth, complications due to other surgeries, or pessaries that are left in too long.

 

Treatment

The majority of fistulas can be treated with repair through the vagina. In some instances a flap of fat from underneath the labia or a flap of skin and muscle may be needed to support the repair especially in instances of recurrent  fistulas. Abdominal or Robotic assisted laparoscopic repairs are also options when the vaginal anatomy prevents adequate exposure or when there has been multiple prior vaginal repairs that have failed. But in general most repairs are done vaginally to provide for the quickest recovery without potential complications that can come with any abdominal approach.