What is Vesicovaginal Fistula?

It is defined as a type of fistula that creates an unnatural connection between the bladder and the vagina. What is vesicovaginal fistula? It occurs as a result of birth trauma, surgical complications or infections. This condition can cause urine to be discharged unintentionally from the vagina. It can cause women to experience problems such as urinary incontinence. Treatment may require surgical intervention.

What are the Symptoms of Vesicovaginal Fistula?

Due to the connection between the bladder and the vagina, urine constantly flows out of the vagina. This can negatively affect hygiene and quality of life. A continuous fluid-like urine discharge from the vagina is observed. This discharge can cause odor and discomfort.

Constant urine leakage increases the risk of infection in and around the vagina. Vaginitis, cystitis and pelvic infections can occur frequently. Skin irritation and dermatitis may occur in the genital area due to constant moisture and urine leakage.

Some patients may experience pain and discomfort in the lower abdomen or pelvic area. Constant urine leakage can cause bad odor in the vaginal area. Vesicovaginal fistula, It can cause pain and discomfort during sexual intercourse. It can negatively affect the social life and psychological state of patients. Social isolation and depression may occur due to constant urine leakage.

People who experience these symptoms should consult a urologist. They should be directed to appropriate diagnosis and treatment methods. Treatment usually requires surgical intervention. Early diagnosis can significantly improve the patient's quality of life.

What Causes Vesicovaginal Fistula?

Excessive pressure applied to the pelvic area during long and difficult birth processes causes tissue damage and vesicovaginal fistula Tears that occur during birth and episiotomy (cutting the vaginal opening to facilitate birth) also cause its development.

During major gynecological surgeries, such as hysterectomy, the bladder or vagina may be damaged. There is also a risk of occurrence during other surgical procedures involving the pelvic area. Severe pelvic infections cause tissue damage and fistula formation.

Recurrent urinary tract infections are also risk factors. Blows or accidents to the pelvic area can cause an abnormal connection between the bladder and vagina. It can also develop as a result of damage to the pelvic organs during sexual assault.

Pelvic radiotherapy used in cancer treatment can cause damage to surrounding tissues. Vesicovaginal fistula may lead to its formation. Chronic inflammatory diseases can predispose to tissue weakness and development. Cancers of the pelvic organs may cause their development by disrupting tissue integrity.

Vesicovaginal Fistula Treatment Methods

Conservative treatment methods are suitable for small and newly formed fistulas. These methods are usually tried before surgical intervention. Some small fistulas may close spontaneously, especially in the first few weeks after trauma. During this period, the patient is advised to drink plenty of fluids.

Catheter placement to provide continuous urine drainage may help the fistula heal. This may encourage the fistula to close on its own. Surgery is the most common treatment method.

Depending on the size and location of the fistula, different surgical techniques may be used. Transvaginal repair involves closing the fistula vaginally. Transvaginal repair is generally suitable for smaller fistulas and has a relatively short recovery time. Transabdominal repair is the preferred method for larger and more complex fistulas. This surgery is performed through an abdominal incision.

Transabdominal repair is a more involved procedure and may require a longer hospital stay. Laparoscopic surgery, a minimally invasive procedure, is performed through small incisions in the abdomen. This procedure can shorten patient recovery time and reduce postoperative pain.

Robotic surgery is a more advanced version of laparoscopic repair. Using robotic arms, the surgeon can perform more delicate and precise procedures. This method may be preferred in complex cases. In cases requiring reconstruction, reconstructive surgery methods can be used.

These methods are particularly effective in large or recurrent fistulas. Flaps are patch-like structures that are placed over the fistula area using healthy tissue. This method allows the fistula to close and the tissue to heal. In some cases, intestinal segments can be used to repair the fistula. This method is preferred in more complex and difficult cases.

Post-surgical care is critical to the recovery process. Certain precautions should be taken to reduce the patient's risk of infection and speed up recovery. Antibiotic therapy may be administered after surgery to minimize the risk of infection.

After surgery, a catheter is required to ensure proper drainage of urine during the healing process. Drinking plenty of fluids and following a balanced diet can speed up the healing process.

What is vesicovaginal fistula?It is a condition that requires attention and care. There are various treatment options, from conservative methods to surgical interventions. Which method is used depends on factors such as the size of the fistula, its location, and the patient's general health. Careful care and follow-up after treatment is critical for the patient's full recovery.