About the disease

Urethro-vaginal fistula is a condition whereby the abnormal passageway forms between urethra and vagina. This passageway can create feeling of discomfort and also affect the general function of urethra. Urethro-vaginal fistula can develop after the women had the surgery to treat incontinence.

Incontinence is a condition whereby the woman is unable to hold urine due to weak bladder control or when there is unintentional urine leakage. After such surgery the passageway can form, so it is important to follow all the medical instructions after the surgery to avoid complications. Urethro-vaginal fistula can also develop after treatment of diverticulitis, which is inflammation of the diverticulum. Women who had prolonged labor or multiple pregnancies can also develop urethro-vaginal fistula due to weakening of pelvic muscles and also due to short-term loss of muscle tone and support needed to keep all the structures in place. It is important to go to the professional gynecologist when having an examination because sometimes urethro-vaginal fistula can develop after unprofessional obstetric intervention.

Traumas of the urethra, such as fracture for example, can also lead to problems with urethra and, consequently, to development of the fistula Some people who have problems with urination and who need to wear catheter for a continuous period of time also develop urethro-vaginal fistula as a response of the body to foreign object. Penetrating and blunt traumas can also be very harmful especially if they had not been treated completely and when they cause some complications. Obesity can become the cause of urethro-vaginal fistula as well, as the muscle supporting pelvic floor becomes weaker.

Symptoms

• General discomfort in the urethra area
• Pain in the lower abdomen
• Pain when urinating
• Pain when having sexual intercourse
• Frequent urination
• Vaginal discharges

Diagnosis

• During a general examination, the doctor will conduct a pelvic exam to rule out other causes that can be manifested in similar ways, such as infections.
• The doctor will check the patient for the signs of inflammation to determine if there had been any changes in the structure of urethra and vaginal walls.
• Imaging tests such as an ultrasound, MRI or CT scan of urethra will be able to identify the passage which would indicate fistula.
• The doctor can also run additional imaging tests to check other internal organs of the woman, such as ovaries, intestines, bowel and colon. 

Treatment

• Surgical closure is the procedure aimed to close the passageway and restore normal functioning of the urethra.
• The doctor can also prescribe some anti inflammatory medications to alleviate the pain if it is present and also to speed up the recovery.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko