To diagnose a vaginal fistula, your doctor likely will perform a pelvic exam, discuss your medical history and identify possible risk factors, such as recent pelvic surgery, an infection or pelvic radiation. Your doctor may also recommend certain tests to help diagnose your condition and to determine treatment options.
Tests for vaginal fistula
Possible diagnostic tests for vaginal fistula include:
- Dye test. In this test, your doctor fills your bladder with a solution dye and asks you to cough or bear down. If you have a vaginal fistula, leakage will appear in your vagina. You may also see signs of leakage on a tampon after physical exercise.
- Cystoscopy. During this exam, your doctor uses a cystoscope — a hollow device equipped with a lens — to view the inside of your bladder and urethra, the tube that carries urine outside of your body, for signs of possible damage.
- Retrograde pyelogram. In this test, your doctor injects dye through your bladder into the tubes that connect your bladder to your kidneys (ureters) and then takes an X-ray. The X-ray image can show your doctor whether you have leakage between a ureter and your vagina.
- Fistulogram. A fistulogram is an X-ray image of your fistula. This test may help your doctor determine whether you have one or many fistulas. Your doctor may also be able to detect what other pelvic organs may be involved with your fistula.
- Flexible sigmoidoscopy. During this test, your doctor uses a sigmoidoscope — a thin, flexible tube with a tiny video camera at the tip — to inspect your anus and rectum.
- Computerized tomography (CT) urogram. During this test, your doctor injects dye into a vein and takes CT scans to create cross-sectional images of your vagina and lower urinary tract.
- Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. With a pelvic MRI, your doctor can determine the path of a rectovaginal fistula.
Read more about CT scan, cystoscopy, flexible sigmoidoscopy and MRI.
April 14, 2014
- Garely AD, et al. Urogenital tract fistulas in women. http://www.uptodate.com/home. Accessed Jan. 22, 2014.
- Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com/resourceTOC.aspx?resourceID=768. Accessed Jan. 23, 2014.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. Nov. 19, 2013.
- DiMarco CS, et al. Vesicouterine fistula: A review of eight cases. International Urogynecology Journal and Pelvic Floor Dysfunction. 2006;17:395.
- Gebhart JB (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 29, 2014.
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