Signs & Symptoms of Vaginal Fistulas

Signs & Symptoms of Vaginal Fistulas

One common question that comes up when we talk about menstrual cups is if pee can get into the menstrual cup. I always find that this is a great time to do some education about pelvic anatomy because not everyone is familiar with their own body. I firmly believe that we all would benefit from more pelvic floor education, normalization, and treatment options. So, let’s get started and explore vaginal fistulas including a bladder and rectal fistula.

vaginal fistulas bladder rectal fistula

Disclosure: This post makes no attempt to diagnose or treat any condition. Please consult with your doctor for individual diagnoses and concerns.

When it comes to the pelvic anatomy of menstruating persons, society as a whole has really fallen short of basic education. I find that people can be unaware of facts like urine comes out of the urethra and menstrual fluids via the vagina and that there are separate canals for each.

I find that most people are unaware that pelvic floor dysfunction, including urinary incontinence, is common and often very treatable. In my opinion, pelvic floor physical and occupational therapy should be one of the most commonly recommended types of therapy because the benefits can be life-changing. More about the pelvic floor here.

While rare, one pelvic anatomy dysfunction is the vaginal fistula. These occur in about 1/200,000 persons and generally need medical tests to be diagnosed. (1) There are several kinds of vaginal fistulas but the basic concept is that there is an opening that doesn’t belong there that lets pee and/or poop into the vaginal canal and causes issues that can include infection, odor, urinary tract infections, irritation and can be hard to diagnose without someone designed to work in this field.

A vaginal fistula differs from a vaginal prolapse including cystocele and rectocele because in a prolapse there is a bulge of anatomy into the vaginal canal and in a fistula, there is an actual hole.

Types of urinary structure related vaginal fistulas: (1, 2)

  • Bladder or Vesicovaginal Fistula – An opening between the bladder and the vagina that allows the passage of secretions between the structures. *This is the most common type seen.
  • Ureter or Ureterovaginal fistula- This happens when an opening develops between your vagina and the ducts that carry urine from your kidneys to your bladder (ureters).
  • Urethral or Urethrovaginal fistula – Occurs when the opening occurs between your vagina and the tube that carries urine out of your body (urethra).


Types of bowel tract related fistulas: (1, 2)

  • Rectal or Rectovaginal fistula – An opening is between your vagina and the lower portion of your large intestine (rectum) often allowing the passage of rectal secretions into the vaginal canal.
  • Colon or Colovaginal fistula – Happens when an opening occurs between the vagina and colon.
  • Enterovaginal fistula – Describes an opening is between the small intestine and the vagina.

How do vaginal fistulas happen?

Vaginal fistulas are often the result of an injury such as trauma to the anatomy including birth, abuse, surgery such as hysterectomy or c-section, radiation treatment, bowel diseases such as Chrone’s or diverticulitis and cancer. I don’t see birth defects listed anywhere but I imagine there could be research into a fistula occurring because of a defect as well (speculation). (1, 2)

Treatment for vaginal fistulas

Basically, a vaginal fistula requires surgery to close off and monitor. The specialized surgeon may use a special patch, your own tissue and fix both soft tissue and muscle to do a proper repair. (1, 2)

Where do you start if you suspect a vaginal fistula?

Go to your practitioner and if this person is unwilling to hear or address your concerns…find someone else. I find it disheartening and frustrating to hear from persons that their OB, Gynecologist or regular doctor dismissed their concerns as general womanly anxiety or worry instead of treating the whole person.

Things only change if we talk about them and help normalize all of these topics and issues.

Thanks so much for stopping by –



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