Prolonged labor, cancers and pelvic surgeries can cause vaginal fistulas. These openings form when vaginal tissue dies, creating a hole (vaginal fistula) between your vagina and organs in the urinary or digestive systems. The most common type, vesicovaginal fistulas, form between the vagina and bladder. Surgery can close a fistula.
A vaginal fistula is a tunnel-like opening that develops in the wall of the vagina. Your vagina is the muscular tube between your vulva (outer female genitals) and your cervix, the mouth of your uterus.
A vaginal fistula opens between your vagina and an organ in the urinary system or digestive system. Damage to tissue in your vaginal wall causes a hole to form where it doesn’t belong.
Genitourinary vaginal fistulas form between your vagina or uterus (parts of the female reproductive system) and organs in your urinary system. The word genitourinary refers to your genitals and urinary system.
The most common type is a vesicovaginal fistula, where an opening develops between your vagina and bladder (the organ that holds urine).
Genitourinary vaginal fistulas also include:
Fistulas can also form between your vagina and digestive system organs. These include:
The World Health Organization (WHO) estimates that 50,000 to 100,000 women worldwide develop vaginal fistulas every year.
The problem is more common among women who live in countries with limited medical resources. These women may spend days in childbirth. Pressure from the baby pushing against the vaginal wall can cut off the blood supply to vaginal tissue, leading to a fistula. As many as 2 million women in Asia and sub-Saharan Africa live with untreated vaginal fistulas.
A lack of blood supply to vaginal tissue causes the tissue to die. A hole or fistula forms in the tissue where this happened. These openings can develop in a few days or over several years. Rarely, a person is born with a congenital vaginal fistula.
Causes of vaginal fistulas include:
Genitourinary vaginal fistulas that form between your vagina and urinary system organs may cause:
Fistulas that form between your vagina and organs in your digestive system may cause:
Diagnostic tests for vaginal fistulas include:
Treatment depends on the fistula type. Some small fistulas heal on their own with treatments like:
Most people with vaginal fistulas need surgery. To repair a vaginal fistula, a surgeon may use your own tissue, lab-made tissue or surgical mesh to close the opening. As many as 9 in 10 women have a complete recovery after vaginal fistula repair surgery.
After surgery for a genitourinary vaginal fistula, you may need help draining urine while the fistula heals. Your healthcare provider can teach you to use a catheter (thin hollow tube inserted into your bladder).
If your provider repairs a large fistula between your vagina and a digestive system organ, you may need a temporary ostomy:
These steps can aid your recovery after vaginal fistula repair surgery:
Surgical treatments for vaginal fistulas are highly successful. Most people experience a full recovery and no longer have symptoms.
Some fistulas don’t heal properly or come back after treatment. Problems with healing are most likely to happen if you have cancer or Crohn’s disease. Living with symptoms of an untreated vaginal fistula can lead to depression or anxiety.
You may want to ask your healthcare provider:
No, you can’t feel a vaginal fistula by inserting your fingers into your vagina. And vaginal fistulas rarely cause pain or discomfort. But you’ll likely notice other signs like leaking urine, painful intercourse or increased infections.
Depending on the fistula type, you may receive care from one or more of these doctors:
A note from Cleveland Clinic
Vaginal fistulas can cause embarrassing symptoms like urinary or fecal incontinence. Women who experience prolonged labor or undergo pelvic surgery are more at risk for developing fistulas. These openings can form between your vagina and organs in your urinary or digestive systems. Tell your provider if you have symptoms. You may be able to heal with nonsurgical treatments. When needed, surgery is highly successful at treating vaginal fistulas.
Last reviewed by a Cleveland Clinic medical professional on 10/28/2021.
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