What is a fistula? - Causes and Types

20 January, 2024

What is a fistula? - Causes and Types

A fistula is an abnormal connection between two organs or an abnormal   connection between an organ and the skin. This irregular link can result in the passage of urine or feces into the body, potentially causing severe and even life-threatening infections.

Fistulas can manifest in various locations, such as between the vagina and the bladder, between the anus and the vagina, or in other parts of the body. In certain instances, fistulas may contribute to issues like rectal or urinary incontinence.

The most common culprits behind fistulas are infections, surgical procedures, radiation therapy, or conditions like Crohn’s disease. These factors can induce tissue damage, ultimately leading to the formation of a fistula. Other potential causes encompass cancer, abscesses, radiation therapy, scar tissue, and trauma.

Possibility Of Different Types of Fistulas

  • An opening between the vagina and the bladder is a vesicovaginal fistula which is the most frequent kind of urinary fistula in women. Mostly it occurs due to a previous hysterectomy or sometimes difficult labor.
  • An opening between the vagina and the urethra is a urethrovaginal fistula
  • An opening between a vagina and a ureter is a ureterovaginal fistula occurring due to pelvic surgery for a prior hysterectomy.
  • An opening between the vagina and the rectum is a rectovaginal fistula.

Occurrence in Men:

Men may experience urinary fistulas as a complication of procedures like chordee repair, hypospadias, or prostate cancer treatment.

Depending on the location of the fistula the doctor may examine the lower colon or urinary tract -

  • Radionuclide cystogram
  • Retrograde cystogram
  • Magnetic resonance imaging (MRI)
  • Computed tomography scan (CT)
  • Ultrasound
  • Retrograde pyelography
  • Intravenous urography


 Urinary Fistula Key Points

  • A urinary fistula is an abnormal connection or opening between a urinary tract organ and another organ
  • Mostly it occurs due to a previous hysterectomy or sometimes difficult labor.
  • It can lead to urine leakage from the vagina due to the abnormal connection.
  • Common causes include trauma, surgery, radiation treatment, and certain diseases.
  • Most of the time the urinary fistula can be repaired with surgery

Causes of Urinary Fistula:

  • Damage to pelvic tissues, urinary tract, or vagina from accidents, injuries, radiation, surgery, or infection.
  • Cesarean section and a hysterectomy are the primary and the largest reasons for vesicovaginal fistula including other surgeries on the back wall of the vagina, anus or rectum, and perineum resulting in fistulas.
  • Deep tears or infections caused due to episiotomy incision for childbirth can cause a fistula.
  • Conditions like cervical or colon cancer, Crohn’s disease, colitis, and diverticulitis can contribute.
  • Malignancies occurring in the pelvic region include cervical cancer or colon cancer
  • Radiation treatment done for pelvic cancer can make tissues fragile and thin
  • Vaginal fistula occurs most commonly in developing regions where adequate health care is not taken such as during very difficult childbirth there can be damage to tissues leading to the opening of the fistula.

What Are the Symptoms of Urinary Fistula?

  • Blood in urine (hematuria)
  • Urine leakage from the vagina
  • Recurrent urinary tract infections
  • Gas or air in the urine
  • Nausea, fever, chills, vomiting
  • Abdominal or pelvic pain

Simple fistulas can be healed on their own as there can be a small possibility of healthy tissues around the fistula where damage has not occurred. Doctors may use the urinary catheter to drain the bladder to heal the fistula and people with ureterovaginal fistula have a small stent placed in the ureter to flow the urine correctly from the kidney to the bladder while the fistula heals.


Most of the time the fistula requires a surgical repair that is done through the vagina or abdomen. In some cases, laparoscopic surgery or robotic surgery is done to repair a fistula. The goal is to bring healthy tissues close to the opening for normal organ function.

About Doctor Dr. Sushila Saini

Dr. Susila Saini, a distinguished Obstetrician and Gynecologist, holds an MBBS degree with a Rotating Internship from SMS Medical College, Jaipur (1999-2005). She earned her M.S. in Obstetrics & Gynecology from Maulana Azad Medical College, Delhi University (2006-2009). Dr. Saini further honed her skills with international certifications, including a Diploma in Minimal Access Surgery from Keil University, Germany (2010), and specialized diplomas in Laparoscopy and Hysteroscopy Surgery.

Recognized as a Pioneer in Laparoscopic Training in Jaipur, she boasts F.MAS (USA) and FICMCH credentials, showcasing her commitment to excellence. Dr. Saini's qualifications also encompass a Diploma in Gynae Endoscopic Surgery from Germany and a Diploma in Assisted Reproductive Technology (ART) from India. With her extensive education and practical experience, Dr. Saini stands as a leading expert in her field, dedicated to providing top-notch care to her patients.

Why Choose Jaipur Doorbeen Hospital Jaipur:

Patients looking for urinary fistula treatment in Jaipur can consider consulting with Dr. Sushila Saini at Jaipur Doorbeen Hospital Jaipur for a trusted and informed approach to urological surgery and medical procedures.