A urinary fistula is an abnormal opening either within a urinary tract organ (such as the bladder) or an abnormal connection between a urinary tract organ and another organ (such as the colon). There are several types of urinary fistulas, including:
Fistulas are most often caused by injury to the organs in question, either during surgery or through trauma, such as an automobile accident. The most common type of urinary fistula results from injury to the bladder during abdominal or pelvic surgery such as a hysterectomy or a cesarean section for childbirth. Other causes of urinary fistula include: pelvic malignancy, such as cervical or colon cancer; radiation therapy; and inflammatory diseases, such as Crohn's disease. The most common cause of colovesical (between the rectum and the vagina) fistula is a disease of the large intestine (diverticulitis).
The symptoms vary depending on where the abnormal connection or opening occurs.
Symptoms related to fistulas between the urinary tract and the vagina (vesicovaginal) may include:
Symptoms of fistula between the rectum and the vagina (rectovaginal) may include:
Other symptoms of urinary fistula could include:
There are other conditions that could also cause these symptoms so your doctor will need to examine you before making a diagnosis.
Your doctor will ask about your symptoms and make a thorough physical examination of the pelvic area. If you have a fistula between the urinary tract and the vagina, the doctor may be able to see it during the examination. Depending on where the fistula is located, the doctor may want to examine the lower colon.
Other tests to visualize the location of the fistula include:
Depending on the type of fistula, some small fistulas that are detected early may be treated by catheter drainage. However, since a fistula is an unwanted connection between 2 organs, the treatment for most fistulas is surgical repair. If you have an infection associated with the fistula, your doctor may also prescribe antibiotics or other medications.
If you need care for urinary or fecal fistulas, these are some of the specialists you might see. Use the filters to get to know the team.