Vaginal fistula care at Mayo Clinic
Your Mayo Clinic care team
Mayo Clinic doctors trained in female reproductive systems (gynecologists and urogynecologists), urinary systems (urologists), intestinal systems (colorectal surgeons) and plastic surgery treat vaginal fistulas.
Having all this expertise in a single place, focused on you, means that you're not just getting one opinion. Your care is discussed among the team. Test results are available quickly and appointments are scheduled in coordination. The most highly specialized experts in the world all work together for you.
Advanced diagnosis and treatment
With state-of-the-art research and lab facilities, Mayo Clinic doctors use advanced technology and sophisticated imaging tests to accurately diagnose vaginal fistula.
Experts at Mayo Clinic also help train new surgeons to do pelvic reconstructive surgery for women.
To diagnose a vaginal fistula, you'll likely have a pelvic exam. Your health care provider will talk with you about your medical history and risk factors. Risk factors might include having inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, recent pelvic surgery, an infection or pelvic radiation.
You may also need certain tests for a diagnosis, including:
- Dye test. In this test, your doctor fills your bladder with a dye solution and asks you to cough or bear down. If you have a vaginal fistula, dye will appear in your vagina. You may also see signs of the dye leakage on a tampon after physical exercise.
- Cystoscopy. During this exam, your doctor uses a hollow device equipped with a lens. The device is called a cystoscope. With the cystoscope, your doctor can see inside the bladder and urethra, the small tube that carries urine outside the body, to check for any problems.
- Retrograde pyelogram. In this test, your doctor injects a substance into the bladder and the tubes that connect the bladder to the kidneys (ureters) and takes an X-ray. The X-ray image can show your doctor if there's an opening between a ureter and the vagina.
- Fistulogram. A fistulogram is an X-ray image of the fistula. This test may help your doctor see if you have more than one fistula. Your doctor may also be able to see what other pelvic organs may be affected by a fistula.
- Flexible sigmoidoscopy. During this test, your doctor uses a thin, flexible tube with a tiny video camera at the end. This device is called a sigmoidoscope. It allows your doctor to check the anus and rectum.
- Computerized tomography (CT) urogram. In this test, you have a contrast material injected into a vein. Then your doctor uses a CT scan to create cross-section images (slices) of the vagina and urinary tract.
- Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves to create detailed images of organs and tissues within the body. With a pelvic MRI, your doctor can see the path of a fistula between the vagina and rectum.
Read more about cystoscopy, flexible sigmoidoscopy, CT scan and MRI.
At Mayo Clinic, your doctor and care team provide you with individualized care to help you manage your condition. Doctors at Mayo Clinic will also coordinate follow-up care with your primary care provider.
Conservative treatment. For a simple vaginal fistula or one with few symptoms, conservative measures may allow the fistula to heal on its own. A simple vaginal fistula may be one that's small or one that's not associated with cancer or radiation therapy.
As part of conservative treatment, you may need constant bladder drainage using a urinary catheter, a flexible tube that drains urine from the bladder. Or you may need to have a ureteral stent put in place. A stent is a small tube that holds the ureter open and helps urine flow from the kidneys to the bladder.
For a simple fistula between the vagina and rectum, you may need to change your diet and use supplements to make stool softer and easier to pass.
Surgery. Most vaginal fistulas require surgery to fix the opening. For a fistula related to inflammatory bowel disease or an infection, you'll need to have that condition treated before you can have surgery.
Depending on where the fistula is, your doctor can do the surgery through the vagina or the abdomen. In some cases, you can have minimally invasive surgery (laparoscopic surgery) or robotic surgery.
You may need to have tissue taken from another area and placed over the repaired fistula to help it heal. This depends on your health history and the size of the fistula. You may also need to have a procedure done that diverts stool from passing through the rectum (colostomy). This will be temporary while you heal from surgery.
Having these procedures done typically involves a multidisciplinary team of surgeons.
Expertise and rankings
An experienced team
Mayo Clinic doctors perform more than 350 vaginal fistula repairs each year. At Mayo Clinic, a team of doctors provides comprehensive care for women with complex pelvic floor conditions, including vaginal fistulas.
Your care team may include doctors trained in women's reproductive systems (gynecologists and urogynecologists), urinary systems (urologists), intestinal systems (colorectal surgeons) and plastic surgery. This multidisciplinary care team works together to provide the best treatment for your condition.
Specialists in women's health
Mayo Clinic researchers seek innovative treatments for many types of gynecologic problems, including vaginal fistula. The Women's Health Research Center at Mayo Clinic focuses on understanding and improving the health of women of all ages.
Learn more about Mayo Clinic's Colon and Rectal Surgery, Obstetrics and Gynecology and Urology departments' expertise and rankings.
Locations, travel and lodging
Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.
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Costs and insurance
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.
In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
Learn more about appointments at Mayo Clinic.
Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.