Genital tract fistula

Question 1

Definition

Answer 1

Abnormal opening that forms between two organs or tissues in the reproductive tract.
Typically between the vagina and another nearby structure, such as the bladder, rectum, or uterus.

Question 2

Aetiology

Answer 2

• Obstetric fistula (MC): They occur when prolonged labour or difficult childbirth causes a tear between the vagina and bladder or rectum
• Surgical complications: After gynaecological surgeries e.g. hysterectomy or c-section. In some cases the surgeon may accidentally damage the bladder or rectum during the procedure
• IBD: Can cause inflammation and ulcers in the intestines, which can lead to fistula formation between rectum and vagina
• Radiation therapy
• Infections: e.g. TB can cause scarring and damage to the tissues of the reproductive system, leading to fistula formation

Question 3

Risk factors

Answer 3

Prolonged labour
Pelvic surgery
Radiation therapy
IBD
STI’s
FGM

Question 4

Symptoms

Answer 4

• Urine leakage
• Faecal leakage
• Vaginal discharge
• Recurrent urinary and vaginal infections
• Pain

Question 5

Diagnosis

Answer 5

• Pelvic exam
• Imaging tests e.g. CT, MRI
• Urodynamic studies
• Cystoscopy/sigmoidoscopy

Question 6

Management

Answer 6

• Referral to a specialist
• Conservative management: (mild symptoms)
  = pelvic floor muscle training
  = the use of absorbant pads
• Surgical management