Treatment

! Surgery is the number one treatment and

cure for your vaginal stula. Your provider
will need to assess the stula and see
whether or not the tissue is healthy or will
need to heal rst.
! If the tissue is needing to heal, often
times antibiotics will be given to reduce
risk of infection and help repair the
tissue
! If the stula was caused by Chrons
disease or Ulcerative Colitis, your
surgeon will make sure the repair is not
done during a symptom are
! If your stula is large in size, a colostomy
may be used (this is when part of your
bowel is cut and stool is re-directed
through a bag outside of your abdomen).
Once the surgery for the stula is
complete, the bowel will be repaired and
there will no longer be a need for the
colostomy bag
! Depending on where the stula is
located, a supra pubic catheter may be
placed to re-direct urine so it is not
sitting in the bladder during surgery.
Again, once the surgery is complete, and
the site has had time to heal the catheter
will be removed
What to Expect After
Surgery
! There is up to a 90% success rate to
repair stulas after surgery.
! The length of recovery depends on where
the stula is located and the overall size of
the hole.
! It may take up to two weeks to heal from
surgery and you may be in the hospital for
up to 14-21 days.
! It may take up to 3-4 months to resume
sexual activity after surgery.
! Menses can return rapidly after surgery, or
may not return at all.
If you have any symptoms, please talk
with your primary care provider!
References
! Goya, K. A., Trivedi, D. S., Dwivedi, U. & Singh, P.
(2009). Our experience with genitourinary stulae.
Urologia Internationalis, 82(4), 404-410
! Holroyd, Beavan, Prentice, Vijay, & Warren (2012).
Colovaginal and colovesical stulae: The diagnostic
paradigm. Technology of Coloproctol, 16, 119-126
! Johns Hopkins Bloomberg School of Public Health
Center for Communication (2004). Obstetric stula:
Ending the silence, easing the su"ering. The Info
Project, 2, 1-12
! Narcisi, L., Tieniber, A., Andriani, L., & McKinney, T.
(2010). The stula crisis in sub-saharan africa: An
ongoing struggle in education and awareness.
Urologic Nursing, 30(6), 341-346
! WebMD (2011). Vaginal stula - topic overview.
Retrieved from http://www.webmd.com/women/tc/
vaginal-stula-topic-overview
Vaginal Fistula
What is it? And why does it
matter?

Madeline Lane, RN, BSN
Research College of Nursing
Diagnosis
! In order to correctly diagnose a vaginal
stula, your provider will need to perform a
pelvic exam that will include the use of a
speculum, much like that of a Pap Smear
test, in order to look for any holes in the
vaginal wall. In addition, your provider may
run some tests that include:
! Complete Blood Count (CBC) - this will
look for any possible infection that has
occurred due to the stula
! Urinalysis with Culture - this will tell your
provider if you have a urinary tract/bladder
infection
! Abdominal X-ray (KUB) or CT scan - to
look for any signs of tissue damage
between the bladder, vagina, and rectum
(not always easy to visualize)
! Dye can also be used in the vagina in order
to tell where the leakage is coming from
(bowel or bladder)
What is a Vaginal Fistula?

! A stula is a hole that can form between
either the vagina and the bladder, the vagina
and the rectum, or the vagina and the bowel.
It causes uncontrollable loss of urine or
stool, or both.
! There are four di#erent kinds of vaginal
stulas, which include:
! Vesicovaginal Fistula: a hole between the
vaginal wall and the urinary tract/bladder
! Rectovaginal Fistula: a hole between the
vaginal wall and the rectum
! Colovaginal Fistula: a hole between the
vaginal wall and part of the colon (large
bowel)
! Enterovaginal Fistula: a hole between the
vaginal wall that opens into the small
bowel.
! In the United States, more than 50% of
stulas occur after hysterectomies, and up
to 600,000 women undergo hysterectomies
annually in the US.
What can cause Vaginal
Fistulas?
! Previous pelvic surgeries (Ex:
Hysterectomy - 1st leading cause)
! Diverticulitis (2nd leading cause)
! Colon Cancer (3rd leading cause)
! Chrons disease or Ulcerative Colitis
! Bladder Cancer
! Radiation Therapy
! Foreign bodies
! Long vaginal labor of child

Symptoms
Change in vaginal discharge
Passing air during urination
Mixing of urine and stool from the vagina
Recurrent urinary tract infections (UTIs)
Abdominal pain
Change in bowel habits
Pain with urination
Blood in urine; Anal bleeding
Weight loss
Loss of control of stool and/or urine
Infection like symptoms (fever, chills, body
aches, overall not feeling well)
Feelings of pressure on the rectum