Though it may not often occur in women outside of third world nations, some women in more developed countries still suffer from the damaging effects of a medical condition called vaginal fistula. A vaginal fistula is a hole that develops in the wall of the vagina, usually caused by some kind of damage to the tissues of the vaginal wall. Whether the tissue breakdown occurs over the course of days or years, most cases are linked to surgical procedures to the back wall of the vagina, the perineum, the anus, or the rectum; open hysterectomy; treatment for pelvic cancer using radiation; inflammatory bowel disease of some kind; childbirth-related tears in the perineum; or infected episiotomies.
Reading the Signs
Unlike many urogynecological disorders, a vaginal fistula does not cause pain, but rather presents itself in symptoms including:
- Urinary incontinence
- Defecatory dysfunction such as the passage of feces into the vagina, causing uncontrollable soiling
- Foul-smelling discharge or gas coming from the vagina
- Sore or infected genitals
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Digging to the Source
A urogynecologist will be able to properly diagnose a vaginal fistula and identify which type it may be in order to determine treatment options. Most common types of vaginal fistula are vesicovaginal fistulas, which open into the urinary tract; rectovaginal fistulas, which open into the rectum; colovaginal fistulas, which open into the colon; and enterovaginal fistulas, which open into the small bowel.
After discussing your symptoms and medical history, your doctor will usually conduct a physical exam, generally using a speculum to look at the vaginal walls for visible signs of damage. Other effective diagnostic methods include the injection of dye into the vagina, the rectum, or the bladder to pinpoint any leaks; a urinalysis, which will identify a urinary infection; a blood test to find any infections that may exist in your body; or an MRI, endoscopy, or X-ray to find areas of damage.
Most women with a vaginal fistula will need surgery in order to repair the problem, though the health of the vaginal tissue itself will need to be determined before any surgical procedures take place.
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