A genitourinary fistula is an abnormal connection of tissue that develops between the vagina and the bladder or other organs in the lower abdomen. Fistulas generally develop as a result of damage to these organs from a number of causes.
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Genitourinary fistulas are common in many areas of the world where high-quality obstetric care is not available. In these cases, the fistula may develop as a result of a long and difficult labor. In developed countries, where obstetric care in generally available, genitourinary fistulas often result from pelvic surgery done to resolve a variety of medical problems. The tissues of the vagina, bladder, or intestines may become damaged during the surgical procedure and a fistula develops.
Bowel diseases, such as Crohn’s disease or diverticulitis can weaken tissues, resulting in fistula development. Infection can also cause fistulas to develop. Severe trauma to tissues, such as those caused by an auto accident, can also cause fistulas. Pelvic or colorectal cancer may cause fistulas to develop, and radiation treatments can also cause fistulas in tissues.
Common symptoms of genitourinary fistula include leakage of urine, stool, or gas from the vagina, wetness of undergarments, odor, irritation of external genitalia, and abscesses. Abdominal pain and frequent urinary tract infections can occur. Some patients develop urinary incontinence. Individuals may be embarrassed by their symptoms and isolate themselves socially. Even getting help for the problem may cause significant embarrassment and distress. However, an experienced urologist can provide appropriate diagnosis and treatment for these problems, repairing the damaged tissues and restoring normal urinary function.
Effective treatments are available that can repair tissues and allow individuals to return to a normal life, without worry or embarrassment about stained clothing and odors.
A variety of tests, such as dye tests, cystoscopy, and sigmoidoscopy, are used to determine the location and severity of the fistula. Other tests may also be used. A number of treatment options are available, depending on the type and severity of the fistula. If the fistula is very small, it may heal on its own, without the need for treatment. Your physician may choose a conservative treatment, such as draining the bladder or the insertion of a stent to hold the ureters open. Physicians can also use a special adhesive compound or natural protein to heal the fistula.
However, in some cases, surgery may be necessary to repair the fistula. Laparoscopic techniques use very small incisions to make these repairs, with tissue taken from the patient’s body. Surgery can also repair muscles that have been damaged by the fistula. Antibiotics and other medications are generally administered during the recovery period.
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