Vesicovaginal Fistula Specialists

What is a Vesicovaginal Fistula?

A fistula is an abnormal passage that develops between two parts of the body. A vaginal fistula connects your vagina to another organ. Vesicovaginal fistula occurs when a passage occurs between the vagina and the bladder. As a result, urine leaks through your vagina.

What Symptoms Develop Due to a Vesicovaginal Fistula?

The primary symptom of a vesicovaginal fistula is incontinence due to the free flow of urine from the bladder through the vagina. If the fistula is small, you may only have slight leakage.

Most women, however, develop continuous incontinence or have symptoms similar to stress urinary incontinence. When you have stress incontinence, urine leaks out when pressure from coughing, sneezing, laughing, and other activities push against the bladder.

What Causes a Vesicovaginal Fistula?

Vesicovaginal fistulas develop when the bladder is accidentally damaged during gynecologic procedures. Most fistulas occur after a hysterectomy for benign disease such as uterine fibroids. Prolonged and obstructed labor can also damage the bladder and lead to a vesicovaginal fistula.

Developing urinary incontinence shortly after pelvic surgery is a red flag that you have a fistula. However, the damaged tissues may slowly form a vesicovaginal fistula that doesn’t cause symptoms until weeks after surgery.

How Do You Diagnose and Treat a Vesicovaginal Fistula?

Your doctor at Associated Urologists of North Carolina performs a thorough exam, which usually includes a pelvic exam, diagnostic imaging, and a cystoscopy. During a cystoscopy, a narrow tube containing a high-definition video camera is inserted through the urethra and into your bladder. 

Your doctor uses the cystoscopy to visually examine your bladder, detect potential problems other than a fistula, and evaluate the size and severity of the fistula.

In rare cases, your doctor may insert a catheter to divert urine and give the fistula time to heal on its own. Most women, however, need surgery to repair the fistula. 

If the fistula is new and the tissues are inflamed, or if the area is infected, your doctor may recommend allowing them to heal before moving forward with surgery. Surgery to close the fistula is most often performed through your vagina. Following your surgery, you’ll have a catheter in place for a few weeks while the area heals. 

If you have incontinence, especially if it occurs after gynecologic surgery, call Associated Urologists of North Carolina today.