A fistula is an abnormal connection between two organs. In this case, the fistula connects an organ in the urinary tract (usually the bladder) with the vagina.
The Urinary Tract
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This procedure is done to repair the abnormal connection between the 2 organs. Fistulas may be caused by:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
The following may also increase the risk of complications:
Your doctor may:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Other things to keep in mind prior to the procedure:
General anesthesia will keep you asleep during the procedure.
The surgery can be done through the vagina or through an incision in the abdomen. You may also have a cystoscopy done during the procedure.
The doctor will insert a catheter (tube) into the urethra. A speculum will also be used to open the the vagina. The doctor will locate the fistula. The walls of fistula will be cut away. The fistula will be closed with sutures. Special dressings will be placed in the vagina.
A small incision will be made in the lower abdomen. Once the fistula is located, its lining will be cut and removed. The tissue will be manipulated so that there is no longer a connection between the urinary tract and the vagina. The vaginal wall and wall of the urinary tract will be repaired. The abdominal wall will be closed. Catheter tubes may be left in place after the procedure to help drain urine. The doctor may also place stents (a type of catheter) in the ureters.
You may have a temporary catheter in your urethra when you wake up.
1-3 hours or longer (depending on how complex the surgery is)
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
This procedure is done in a hospital setting. The usual length of stay is:
After the procedure, the hospital staff may do the following:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
You may have to restrict your activities during your recovery until you have permission from your doctor. You may be given specific exercises to do at home to promote healing and maintain strength. Pain can be managed with medications. Avoid sexual intercourse until your doctor says it is okay.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
Family Doctor—American Academy of Family Physicians
American Congress of Obstetricians and Gynecologists
The Society of Obstetricians and Gynaecologists of Canada
Jatoi N, Jatoi N, Shaikh F, Ssirichand P. Key to successful vesico-vaginal fistula repair: an experience of urogenital fistula surgeries and outcome at gynecological surgical camp 2005. Ayub Medical College website. Available at: http://www.ayubmed.edu.pk/JAMC/PAST/20-2/Nasreen.pdf . Accessed September 26, 2014.
Rizvi S, Gupta R, Patel S, Trevidi A, Trevidi P, Modi P. Modified laparoscopic abdominal vesico-vaginal fistula repair. J Laparoendoscopic and Advanced Surg. 2010;20(1):13-15.
Last reviewed August 2014 by Andrea Chisholm
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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