Genital organs and urinary tract openings

Description of Fistulas

Fistulas, also known as fistulae, are disruptions of continuity, disturbing the function of one or several organs, when adjacent organ ducts or cavities pathologically join, occurring due to trauma or necrosis of organ wall tissues. The forms of connection are classified as follows:

a) vagina – urethra;

b) vagina – urinary bladder;

c) cervix – urinary bladder;

d) uterus – urinary bladder;

e) vagina – ureter;

f) vagina – colon;

g) vagina – small intestine.

The causes of fistulas are various. The most important ones are:

a) compression of soft birth canals against the pelvic walls when the fetal head remains in one position for a long time;

b) complicated delivery, requiring the use of forceps or other instruments;

c) damage to the urinary bladder, ureters, or intestines during complex gynecological surgeries. This occurs very rarely;

d) Shrinking tumor or metastases in the vagina, urinary bladder, or rectum;

Symptoms

Flow of urine, gas, or feces through the vagina. Often complicated by inflammation of the urinary bladder, ureters, or cervix.

Diagnosis

During examination, the flow of urine or feces through the vagina is observed. Then a gynecological examination and a rectal examination are performed. X-ray and cystoscopic (internal examination of the urinary bladder) tests, pyelography (contrast is injected and its flow is observed) are informative.

Treatment

Treatment can be conservative or surgical. When fistulas are small, they can be cured with catheters, drains, stents, special plugs, etc. However, for a good effect, surgical treatment is usually applied – the fistula is removed, and the area is sutured with absorbable sutures.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology