What Is a Vesicovaginal Fistula?
A vesicovaginal fistula is an irregular opening between your bladder and vagina. This causes urine to leak out of your vagina. Usually, urine should only exit your body through your urethra (tube at the bottom of your bladder).
You may have only one irregular opening, or you may have more than one. The size of these openings can also vary.
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Vesicovaginal Fistula Causes
Vesicovaginal fistulas are usually a complication of gynecologic or urologic surgery. Any surgery on your pelvic area could lead to a fistula:
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Bladder repair
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Sling procedures to treat urinary incontinence
Radiation to your pelvis can also cause a vesicovaginal fistula. Some people have radiation therapy to treat gynecologic cancer. Damage from radiation may get worse slowly and over a long period. So, vesicovaginal fistulas can develop many years after your radiation treatment.
Prolonged labor during childbirth can cause vesicovaginal fistulas. However, this happens most often in areas without access to modern obstetric care. Prolonged labor rarely causes vesicovaginal fistulas in the United States. But, complications from C-section and difficult child birth can still cause some fistulas.
Vesicovaginal Fistula Symptoms
The main symptom of a vesicovaginal fistula is urine leakage (urinary incontinence). The amount of urine you leak can be large or small, depending on the size of your fistula.
It’s important to understand that there are many causes of urinary incontinence. Vesicovaginal fistulas are a rare cause. Your provider will work with you to diagnose and treat your symptoms.
Vesicovaginal Fistula Risks
Long-term urinary incontinence is uncomfortable. Many women want to get a vesicovaginal fistula repair to relieve this discomfort. But there aren’t major health risks associated with vesicovaginal fistulas.
Vesicovaginal Fistula Diagnosis and Testing
Your provider will ask you about your symptoms and review your health history. They will ask whether you’ve had gynecologic surgery or pelvic radiation in the past.
They may also use several tests to diagnose or rule out a vesicovaginal fistula:
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Cystoscopy: We insert a flexible, lighted tube (cystoscope) through your urethra to get a close look at your bladder. This is similar to having a catheter placed in your bladder. It does not require you to fast, and you don’t need sedation or anesthesia.
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Tampon test: You get an intravenous (IV) line with a special dye. You also wear a fresh tampon. The color the tampon turns will tell us whether you could have a vesicovaginal fistula.
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Urinalysis: We test a urine sample to rule out other conditions, such as infections, that could cause similar symptoms.
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X-rays: These tests use a tiny dose of radiation to get a picture of the inside of your body.
Vesicovaginal Fistula Treatment
Your treatment plan depends on the cause and location of your fistula. Your urologist will work with you to find the best way to treat your condition:
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Chronic (long-term) catheter—We place a catheter (tube) in your bladder. This tube drains urine into a bag outside your body to avoid leakage.
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Surgery—The surgical approach that’s right for you depends on your fistula’s location and your anatomy. We may use one of the following approaches for your surgery:
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We will insert surgical tools through your vagina to repair the fistula.
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We will make an incision in your abdomen to access and repair the fistula.
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Recovery from Vesicovaginal Fistula Surgery
Vesicovaginal fistula surgery is usually an outpatient procedure, so you can go home the same day. But you may need to stay in the hospital overnight if we make an incision in your abdomen. We use stitches and several layers of healthy tissue to close the fistula hole. You will have a catheter in your bladder for about three weeks in order to allow you to fully heal. Your total recovery time will depend on several factors, including your overall pain and the surgical approach. Most people take the full three weeks off work while the catheter is in place.
You will continue to see your surgeon regularly after surgery. Your surgeon will monitor your healing and manage any complications if they arise.
Why Choose University of Utah Health?
Our urology team includes fellowship-trained pelvic medicine and reconstructive surgeons that specialize in bladder reconstruction. These surgeons have extra training and expertise in reconstructive pelvic bladder surgery. And every member of your surgical team is experienced with fistula repair. We take a specialized, personalized approach to your care and offer you the treatment plan that’s right for your needs.
Make an Appointment
Call 801-213-2700 to make an appointment with our urology surgeons. We don’t require referrals, but some insurance plans do. We recommend checking your insurance coverage before scheduling an appointment.
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