For vaginal fistulas, conservative (nonsurgical) therapy is sometimes effective. However, in most cases, vaginal fistulas require surgery to close the opening.
If you have a simple vaginal fistula — for instance, your fistula is small in size, you haven't had cancer or you've never had radiation therapy — conservative measures may allow your fistula to heal on its own.
As part of your therapy, your doctor may recommend constant bladder drainage using a urinary catheter. Placing a ureteral stent — a small tube that holds the ureter open and helps urine flow from the kidneys to the bladder — soon after symptoms appear may help heal an otherwise uncomplicated ureterovaginal fistula. If you have a simple rectovaginal fistula, your doctor may ask you to change your diet and use fiber supplements to bulk your stool.
Most vaginal fistulas require surgery to repair the abnormal opening. Doctors can treat vaginal fistulas with surgery through the vagina or abdomen. Some cases can be treated with minimally invasive surgery (laparoscopic surgery), including robotic surgery. The location of your fistula determines whether your surgeon can perform the procedure through your vagina or your abdomen.
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.