A urinary fistula is an abnormal opening between the urinary tract organ that processes urine and carries it out of the body. A fistula can also form an abnormal connection between a urinary tract organ and another nearby organ such as the vagina or colon.
Various types of fistulas are mainly caused by injury to the organs, either during surgery or trauma.
Fistulas are more common in women. Men experience other types of fistulas as a complication of hypospadias or chordee repair.
Fistulas are painless, and the symptoms vary depending upon where the abnormal connection occurs.
The most common type of urinary fistula occurs from injury to the bladder during
The doctor will perform a thorough physical examination of the pelvic area. If the fistula is between the urinary tract and the vagina, then the doctor will be able to know during the examination.
The doctor would like to test to find the type, location, and severity of the fistula to recommend treatment options.
Depending on the type of fistula, the doctor may help the patient's urinary tract function correctly without urine passing through the fistula.
Small fistulas that are detected early in the stage can be treated by a urinary catheter to drain the bladder.
Some patients who have a ureterovaginal fistula may have a small stent placed in the ureter. The stent makes the urine flow correctly from the kidneys to the bladder while the fistula heals.
Since a fistula is an unwanted connection between two organs, the treatment for most fistulas is surgical repair.
Some surgeries are done through the vagina and some through the abdomen. For some laparoscopic is done which uses only small incisions or with robotic surgery that involves very precise movements.
The surgery is done to repair the fistula so that, healthy tissue can grow and close the fistula opening, and restoring the normal function of the organs that are affected. The surgeon will remove the damaged tissue or the tumor that could be affecting the fistula.
If the fistula is large and is related to the bowel or colon then colostomy is recommended before the surgery. The procedure will keep the fistula clear for the surgery. After the area of the fistula heals, the doctor will be able to remove the colostomy.
After the surgery:
Most patients will have a catheter in the bladder for 12-14 days and it is removed once the fistula area is healed.
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