“Vesico” refers to the “urinary bladder”. “Vagina” is a tubular canal that forms a part of the female reproductive system, which extends from the womb to the exterior of the body. A Vesico vaginal fistula is an abnormal tract that is created between the urinary bladder and the vagina. This tract causes urine leakage through the vagina.
“Ureters” are two long tubular structures that drain urine from the bladder to the outside of the body. A uretero vaginal fistula is the formation of an abnormal tract between ureter and the vagina. So the urine flowing through the ureters leaks out through the vagina.
Causes of vesico Vaginal Fistula
This is the most common cause of Vesico vaginal and urethro vaginal Fistula. Since the bladder lies immediately close to the womb and vagina, any surgery to the bladder, vagina or womb may result in creation of an abnormal tract between the vagina and bladder.
Due to poor nutrition, the hip bone structure tend to be weak and poorly developed. So the mother has a hard time delivering the baby. Sometimes special instruments are used to pull the baby out. During this time while the mother tries to push the baby out, the baby’s head puts pressure on the blood vessels of the birth canal. This may, at times, cut off the blood supply. This leads to tissue necrosis and makes the area vulnerable to fistula formation.
Radiation treatment also causes progressive damage to the tissues surrounding the vagina, resulting in formation of fistulas.
Prolonged child birth
Another cause that can weaken the muscles of the vagina and womb causing fistula formation.
Symptoms of vesico Vaginal Fistula
- Urine leak through the Vagina.
- Incomplete emptying of urine.
- Vaginal irritation and itching.
Diagnosing vesico Vaginal Fistula
A thin long tube is inserted into the urinary bladder. This instrument has a camera and light at the inserted end, which help to identify the exact location, and size of the fistula. MORE…
An Intravenous Pyelogram is a technique in which a colored dye is passed through the vein. This dye passes through the urinary bladder, ureters and urethra. An X Ray picture is taken. Through this technique, presence of additional fistulas can be identified. MORE…
Treatments for vesico Vaginal Fistula
By placing a tube in the bladder to drain urine, the fistula is allowed to heal on its own. This is usually recommended in fistula formed due to surgical injury. When fistula do not heal on their own they need to be closed surgically.
The fistula is disconnected and the two openings in the wall of the bladder and the vagina are closed. Some fat is pushed in between to keep the openings apart.
Prevention of vesico vaginal fistula
Prevention is the key to ending fistula formation in women:
- Ensure proper and timely management during childbirth.
- Encourage adequate diet and nutrition for mothers during pregnancy.
- Avoid frequent high dose radiation exposures.
- Surgeries must be done by well trained, well experienced surgeons.
Boari Reconstruction Specialists
Dr. J. S. Rajkumar
M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)
Dr. Ilamparuthi Chennakrishnan
GENITO- URINARY SURGEON
M.B.B.S., M.S. (General surgery), M.Ch. (Urology), D.N.B. (GUS), F.I.C.S.