A fistula is a connection between two organs. This procedure is done to repair a fistula between the urinary tract (usually the bladder) and the vagina.
The Urinary Tract
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A vesico-vaginal fistula repair is done in women with a fistula, which may be caused by:
Complications are rare. But, no procedure is completely free of risk. If you are planning to have vesico-vaginal fistula repair, your doctor will review a list of possible complications, which may include:
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 medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Other things to keep in mind prior to the procedure:
General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It will be given through an IV (a needle placed in your arm).
You will be prepared for surgery. IVs will be placed in your arm or hand for medicines and fluids.
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 prevents pain during surgery. Pain or soreness during recovery will be managed with pain medicine.
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:
When you return home, do the following to help ensure a smooth recovery:
After you leave the hospital, contact your doctor if any of the following occurs:
If you think you have an emergency, call for medical help right away.
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 August 19, 2010.
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 December 2013 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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