Fistula between bladder, vagina, or rectum (obstetric fistula)

Overview

Obstetric fistula is common in places without access to C-sections but rare in the U.S.

Surgery can repair most fistulas.

Symptoms

Common signs:

• Constant leaking

Less common

• Skin irritation

When to get medical care

Causes

Injury.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Women with long labor and no access to C-section: Highest risk
• People after pelvic surgery or radiation: Higher risk

Possible complications

• Urinary tract infection (UTI): From leaking urine
• Depression: Common from shame and isolation

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

• Exam:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

• Use pads and skin barrier cream

Prevention

To lower your risk or prevent problems:

• Access to timely childbirth care

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a gastroenterologist or a colon and rectal surgeon.

Living with it

Support groups and helplines

• Genetic and Rare Diseases Information Center (GARD): Free NIH information on rare diseases, including where to find experts and patient groups.
• National Organization for Rare Disorders (NORD): Patient groups, help finding care, and aid programs for rare diseases.

Children, pregnancy, and older adults

• People with past pelvic radiation: Higher risk.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Most heal after surgery.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What's causing this?
• What treatment do you recommend?
• Can this be repaired?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Fistula between bladder, vagina, or rectum (obstetric fistula)