Different Types of Fistula and Treatments!

A fistula is an abnormal, tube-like connection, a passage or hole that forms between two organs or an organ in your body and your skin. There are various types of fistulas that can develop in different parts of your body but the most common types are-

1. Obstetric Fistulas: This is the name given to a hole between the vagina and rectum or bladder. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula and one that opens into the rectum is called a rectovaginal fistula. 

A woman with obstructed labour or labour that is not attended by a doctor or a midwife, can suffer labor pain for up to six or seven days. And as the labour produces contractions that push the baby’s head against the mother’s pelvic, the soft tissues between the baby’s head and the pelvic bone are compressed and do not receive adequate blood flow between the mother’s bladder and vagina and/or between the rectum and vagina.
This means that a hole forms on the vaginal wall between the urinary tract and her rectum. The urine and faeces thus start to leak from the vaginal opening causing soiling and foul smell.

Apart from labour, hysterectomies that damage the vaginal wall can also cause such types of fistulas.

Enterovaginal – A woman may have gas and foul smelling fluids leaking out of her vagina due to an enterovaginal fistula which is a hole between the vagina and the digestive tract. It’s usually caused due to inflammatory bowel disease or IBD and ulcerative colitis.

2. Anal fistula

These are fistulas that form between the end of the bowel and skin near the anus.

An anal fistula usually develops due to a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus due to an acute infection in the internal glands of the anus.

Common symptoms are:

• Pain in the anorectal area
• Swelling
• Redness
• Fever
• Rectal bleeding
• Urinary symptoms, such as trouble initiating urination or painful urination

Causes:

• Inflammatory bowel disease – a chronic condition of the GI track which causes inflammation
• Diverticulitis – An infection in the large intestine
• Tuberculosis, HIV
• Surgery near the anus

Anal abscess and likewise anal fistula are treated by surgical drainage in which an incision is made in the skin near the anus to drain the infection causing an anal abscess. Hospitalization may be required for patients who have impaired immunity like diabetics.

Anal fistula though has no medical treatment and surgery is almost always necessary to cure it.

• If the fistula is straightforward which means one that involves minimal sphincter muscle, a fistulotomy may be performed. This involves cutting open the whole length of the fistula so it heals.
• Seton is another procedure in which a surgical thread called a seton is placed in the fistula and left there to help it heal. If you wish to discuss any specific problem, you can consult a general surgeon.