Urinary fistulas arising in a women is a complex and multi faceted problem. Apart from a cause of grave concern and psychosocial issues in the women herself, it can cause tension and emotional distress to the family, including the newborn if it is a case after child birth.
Dr Rahul Gupta is a Consultant Urologist in Fortis Hospital Noida specialising in Urogynecology in Noida and have special interest in the management of Gynecological Urinary fistulas like Vesicovaginal fistula (VVF) and Ureterovaginal fistula (UVF)
Urinary fistulas present as continuous urinary leakage in women. This chronic incessant leakage causes wetting, bad smell, skin soiling infections and may lead to the woman becoming a social outcast, either by choice or by societal pressure. Female urinary fistulas is a pertinent cause of incontinence or urinary leakage in women. Most women decline treatment because of embarrassment or shame.
Vaginal fistulas can develop as a result of an injury, a surgery, an infection or radiation treatment. Whatever the cause of your fistula, you may need to have it closed by a surgeon to restore normal function.
Types of Gynecological Urinary Fistulas
There are several types of vaginal fistulas:
- Vesicovaginal fistula. Also called a bladder fistula, this opening occurs between your vagina and urinary bladder and is the type that doctors see most often.
- Ureterovaginal fistula. This type of fistula happens when the abnormal opening develops between your vagina and the ducts that carry urine from your kidneys to your bladder (ureters).
- Urethrovaginal fistula. In this type of fistula, also called a urethral fistula, the opening occurs between your vagina and the tube that carries urine out of your body (urethra).
- Rectovaginal fistula. In this type of fistula, the opening is between your vagina and the lower portion of your large intestine (rectum).
- Colovaginal fistula. With a colovaginal fistula, the opening occurs between the vagina and colon.
- Enterovaginal fistula. In this type of fistula, the opening is between the small intestine and the vagina.
Causes of Gynecological Urinary Fistulas
- In the age of Hysterectomy or Uterus removal due to many causes, an unintended sequelae is formation of a supratrigonal VVF or Vesicovaginal fistula.
- Obstetric or Child birth– Obstructed labor or stuck baby, especially in Indian Women can cause large complicated fistulas that are difficult to treat. Occurring mostly in rural areas, but still occasionally seen in urban or rural centres.
- Women unfortunate to have Cancer of the cervix or Endometrium may develop a urinary fistula
- Some fistulas are never characterised and are an enigma for any treating urologist