Vaginal Fistulas

Treatment

Conservative therapy

Non-surgical treatment is used only in cases of simple vaginal fistulas. For a fistula to be considered simple, the patient must have no history of radiation or malignancy. Some simple fistulas may respond to at least four weeks of constant bladder drainage. For simple rectovaginal fistulas, the patient may be asked to modify their diet and use fiber supplements.

Surgery

Most fistulas require surgical repair. The fistula site determines the surgeon's approach, either through the abdomen or the vagina. The surgeon may introduce a new tissue source if the original tissue has died or the blood supply is poor. The first surgical repair of a fistula has the best chance of success.

Fistulas related to Crohn's disease (usually rectal fistulas) might require a partial proctectomy (surgical removal of a portion of the rectum).