UROGENITAL FISTULA

What is urogenital fistula?

Abnormal connection between bladder, the female genital tract and the bladder, urethra, or ureters is known as a urogenital fistula.There are two common types of urogenital fistulas

• Vesicovaginal fistula- vaginal fistula opening in urinary tract
• Ureterovaginal fistulas- vaginal fistula opening in ureter

Vesicovaginal fistula is about three times more common than ureterovaginal fistulas, however, in extremely rare conditions these two can occur simultaneously.

Causes

A fistula starts with any kind of damage to the tissue and then opens up. Various causes for this can be:

• surgery of vagina, anus or rectum
• Hysterectomy
•  inflammatory bowel disease
• treatment for pelvic cancer
• infected  episiotomy

Symptoms

• urinary incontinence- inability to control urination
• overflow incontinence
• infected or sore genital area
• foul-smelling discharge from vagina
• foul-smelling gas from vagina

Diagnosis tests

• physical examination of the pelvic region
• dye-test -A dye is injected into the bladder, and its path is traced using imaging techniques
• blood test
• urine analysis
• X-ray
• Endoscopy
• MRI

Treatment

It is usually treated with surgery but before that certain treatments may be done so that the surgery is possible-

• Medicine to heal the tissue
• Colostomy to keep the fistula clear
• Surgery

It is necessary to take full care after surgery and see the doctor if there are any post-surgery rashes, tenderness, swelling or fever.

Post surgery

• After surgery, the patient will be asked to urinate to test the response of the bladder and urethra to the surgery.
• An overnight stay is rarely needed after a laparoscopic surgery. However, in case of open surgery, the recovery period is longer.
• There might be mild pain in the abdomen after the surgery, which is normal
• The doctor should be reported to periodically after the surgery, to check for proper functioning of the bladder
• Any bleeding or abnormal discharge from the vagina should be immediately reported to the doctor

"Authored By Dr.Niraj Mahajan"