Urinary Fistulas 

Urinary fistulas are irregular openings between organs in the urinary tract. 

Irregular openings in the urinary tract that allow urine or stool to pass through areas they normally wouldn’t are known as urinary fistulas. They can also be formed by abnormal connections between urinary tract organs.  

Some of the different types of urinary fistulas include: 

• Vesicovaginal fistulas - openings between the vagina and the bladder and are the most common type of urinary fistula 
• Enterovesical fistulas - openings between the bladder and bowel  
• Vesicouterine fistulas - openings between the bladder and uterus 
• Ureterovaginal fistulas - openings between the vagina and ureter ducts 

The condition is most common in females, but men may develop certain types of urinary fistulas as a complication of hypospadias or other conditions. 

Causes of Urinary Fistulas 

Urinary fistulas usually form when tissues in the urinary tract are damaged. This can stem from a number of causes, including: 

• Injuries or accidents 
• Medical procedures such as surgery and radiation 
• Infections (less common) 

Other causes include: 

• Hysterectomies and caesarean sections (which are responsible for the largest number of vesicovaginal fistulas) 
• Malignancies such as colon or cervical cancer 
• Inflammatory bowel disease or diverticulitis  

Symptoms of Urinary Fistulas 

Because most females with urinary fistulas experience no pain, urinary fistulas are generally discovered based on symptoms such as: 

• Urine and other fluid leaking from the vagina 
• Feces leaking into the vagina 
• Regularly experiencing urinary tract infections (UTIs) 
• Passage of gas from the urethra during urination 
• Pain in the abdomen 

Diagnosis of Urinary Fistulas 

Diagnosing a urinary fistula begins with an examination by a physician, followed by a discussion regarding the patient’s medical history. The physician may then recommend further testing, such as:

• A urine sample, which will identify infections or other problems in the urinary tract 
• Magnetic resonance imaging (MRI) 
• A cystogram, in which the bladder is filled with dye to help identify the location of the urinary leakage 
• A fistulogram, in which X-ray imaging is used to identify both the presence of a fistula and which organs are being affected by it 

Treatments for Urinary Fistulas 

The urological experts at Tampa General Hospital treat urinary fistulas with a patient-first approach. Treatment options include both conservative therapy and surgery. Conservative therapy can be effective in situations where the urinary fistula is small and the area surrounding it is healthy. Instances where the urinary fistula is larger often warrant surgery, which is typically performed through either the vagina or the abdomen.