Fistula- overview, causes, symptoms, types, and treatment



A fistula is an abnormal connection between two organs or veins that is formed by a tunnel-like opening. Fistulas can develop in a variety of locations across the body. Fistulas involving the vaginal and urinary systems are the most prevalent in women and are caused by protracted or obstructed childbirth, pelvic surgery damage, infection, inflammation, or radiation treatment in the pelvis or genital area.

FISTULAS TYPES

ANAL AND PERIANAL FISTULAS

  • An abnormal connection between the anal canal's epithelialized surface and the perianal skin.
  • An anorectal fistula is a connection between the anal canal and the skin around the anal entrance.
  • When a hole develops between the rectum or anus and the vagina, it is called a rectovaginal or anovaginal fistula.
  • A colovaginal fistula is a connection between the colon and the vagina.

URINARY TRACT FISTULAS

  • Openings within a urinary tract organ that are aberrant, or a link between a urinary tract organ and another organ that is abnormal.
  • The bladder and the uterus form a vesicouterine fistula.
  • A vesicovaginal fistula is formed when a hole forms between the bladder and the vagina.
  • The urethrovaginal fistula is a connection between the urethra and the vagina.

OTHER TYPES

  • An enteroenteric fistula is a connection between two sections of the intestine.
  • An enterocutaneous or colocutaneous fistula is a connection between the small intestine and the skin, or between the colon and the skin.
  • Fistulas, if left untreated, can be distressing, debilitating, and cause more injury to your health. Fistulas are linked to nerve injury, infection, and kidney failure.

What causes fistula

  • The creation of a fistula on the human body can be caused by a number of factors. As previously noted, some may form spontaneously, while others may be the result of an injury or surgery.
  • The most frequent type of fistula, anal fistula, can develop gradually over time. A fistula can sometimes occur between the gut and the vagina. This is also natural.
  • Those suffering from gastrointestinal disorders such as Crohn's disease, colitis, and irritable bowel syndrome, on the other hand, are more likely to develop a fistula near the anus. After childbirth, women may also develop a fistula between the anus and the vagina.

Symptoms of Fistula?

  • Urine leaks from the vaginal opening on a regular basis
  • Irritation of the female genital organs on the outside
  • Urinary tract infections are common (UTIs)
  • Leakage of gas and/or feces into the vagina
  • Fluid drainage from the vagina
  • Nausea
  • Vomiting
  • Diarrhea
  • ain in the abdomen

Diagnosis

Your symptoms and medical history will be discussed with the professional. The doctor will look for a fistula opening near your anal orifice during your physical exam

Examine the fistula A long, thin probe is passed through the fistula's outer orifice. To determine where the fistula opens up on the inside, a specific dye may be injected. Anoscope. This is a specialized scope that is used to examine the inside of your anal canal.

Imaging studies These may include an ultrasound, which uses sound waves to create an image of the anal area. They could also include an MRI, which uses special magnets, and a computer to create images of the affected area.

Treatment

Fistulotomy This operation opens up the fistula so that it can heal from the inside out. It is normally performed as an outpatient operation. This means you will return home the same day. Using a particular adhesive or plug to close the fistula. This is a novel type of treatment that seals the fistula's inner entrance. The fistula tunnel is then filled with a substance that your body will absorb over time, according to the doctor.

Reconstructive surgery often known as staged surgery, is a type of surgery that is performed in stages. In some circumstances, this may be a possibility.

Seton placement This method involves inserting a suture or rubber band (seton) into the fistula and gradually tightening it. It allows the fistula behind the seton to heal and lowers the chance of incontinence.

Managing anal fistula

Take pain medication as suggested by your surgeon while recovering after anal fistula therapy. Complete all of your antibiotics. Do not take any over-the-counter medications without first consulting your healthcare physician.
  • Taking a warm bath 3 to 4 times per day
  • Wearing a pad over your anal area till it heals
  • Resuming normal activities only when your surgeon has given you the all-clear.
  • Consuming a high-fiber diet and drinking plenty of water
  • As needed, use a stool softener or bulk laxative.