pelvisawareness_adminDoctor's Corner, Incontinence

Urinary Tract Fistulas

Urinary incontinence is a complex condition that affects millions of women. Incontinence greatly impact quality of life, damaging relationships, impacting self esteem, and leading to mental health concerns like social anxiety and isolation.  

Urinary tract fistulas can cause urinary incontinence, even though many women are not aware a fistula is the cause of their symptoms. This is another reason why women who are experiencing incontinence should seek out medical attention.

Thank you to fellowship trained female urologist Dr. Samir Derisavifard of USMD Urology in Dallas-Fort Worth, who shared much of the following insights on urinary track fistulas.

What Is A Fistula?

A fistula is a communication between two hollow parts of your body, either a connection or a hole.

Fistulas can involve any hollow organ in the body. As such, fistulas can involve the bowels, the skin, and many parts of the urinary or reproductive tracts. The most common type of fistulas for women involve the communication between the bladder and the vagina.

In general, for the United States and most western countries in general, these fistulas are caused by post-surgical complications of some sort. This generally means having had a hysterectomy in which the bladder is affected or injured. The impacted bladder can heal in such a way that a fistula develops.

In developing countries, fistulas are more often an obstetrics issue, in which an unborn child presses on the birth canal too tightly for too long, without treatment.

Fistulas are typically diagnosed because of some type of ongoing incontinence issue, often when the patient doesn’t know what’s going on. Because the bladder and vagina are connected, urine will drip uncontrollably. This may not be painful, but it can be uncomfortable and lead to soreness or infection.

Other symptoms of fistulas include pain during intercourse, diarrhea, abdominal pain, weight loss, nausea, and vomiting.

All About Fistulas

Treating Fistulas

Aside from a physical exam, your doctor may also use blood tests, x-rays or scopes to help diagnose your condition.

In general, when a fistula is not treated, the tract matures. Essentially, the communication or the tract that forms between the bladder and vagina can form a lining that doesn’t go away on its own.  

Thankfully, although fistulas won’t heal on their own, they can often be treated with minimally invasive procedures.

Treatment typically requires some type of surgical procedure to excise or remove the whole fistula tract.  You also need to repair the defect in a number of layers to make sure that it doesn’t come back again in the future.

Finally, remember that urinary incontinence can be caused by a number of factors, many of which are treatable. There is no reason to suffer in silence, especially since many of these conditions can be worse over time if not treated promptly. In fact, taking action early can help make treatment simpler and easier.

Incontinence is not a given just because you’ve given birth or you’re getting older (see more incontinence myths here), or even if you’ve had a hysterectomy. You can speak to your family doctor about your concerns, or use our Physician Finder to seek out a pelvic health specialist in your area.