Vaginal Fistulas

Overview

Gynecologists, urogynecologists, urologists and colorectal surgeons at all three Mayo Clinic locations specialize in treating vaginal fistulas. Mayo surgeons perform more than 100 surgeries for fistulas each year and help train new surgeons in the specialty of female pelvic medicine/reconstructive surgery.

Diagnosis

A thorough history often identifies risk factors that may lead to a vaginal fistula, such as recent pelvic surgery, infection or prior pelvic radiation. An initial exam usually includes a visual exam with a speculum. Diagnostic tools include dye tests, cystoscopy, retrograde pyelograms, fistulagrams and other imaging studies. These help physicians determine if surgery is necessary. Read more about diagnosis of vaginal fistulas.

Treatment options

Conservative (nonsurgical) therapy is rarely effective; most vaginal fistulas require surgery to close the opening. Vaginal fistulas are usually treated with surgery through the abdomen or vagina. Some cases can be treated with laparoscopic or robotic surgery. Read more about treatment of vaginal fistulas.

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About vaginal fistulas

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A vaginal fistula is an abnormal passage that connects the vagina to other organs, such as the bladder or rectum, resulting in leakage of urine or feces into the vagina. A vaginal fistula could also be described as a hole in the vagina that allows stool or urine to pass through the vagina.

Fistulas may result as a complication of pelvic surgery — more than 50 percent occur after hysterectomies. They may also develop after injury to the pelvic area, infection, inflammation or radiation treatment.

Vaginal fistulas are classified into four types; treatment varies for each:

• Vesicovaginal fistulas, also called bladder fistulas, occur between the vagina and urinary bladder. This is the most common type of vaginal fistula.
• Uterovaginal fistulas occur between the vagina and distal ureter (ureters are ducts that carry urine from the kidney to the bladder)
• Urethrovaginal fistulas, also called urethral fistulas, occur between the vagina and urethra (tube that carries urine out of the body)
• Rectovaginal fistulas, also called rectal fistulas, occur between the vagina and the rectum