Materiały źródłowe

• #1 Vaginal Fistula: Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22079-vaginal-fistula

  Prolonged labor, trauma and pelvic surgeries can cause vaginal fistulas. […] A lack of blood supply to vaginal tissue causes the tissue to die or become damaged. A hole or fistula forms in the tissue where this damage occurs. These openings can develop in a few days or over several years. Rarely, a person is born with a vaginal fistula. […] Causes of vaginal fistulas include: Prolonged labor during childbirth. Vaginal tears during childbirth or an episiotomy. Abdominal or pelvic surgery, including C-sections and hysterectomies. Cancer in your pelvic area, like cervical cancer or colorectal (colon) cancer. Inflammatory bowel diseases (IBD) like Crohns disease and ulcerative colitis. Colon infections like diverticulitis. Radiation therapy to the pelvic region. Trauma or injury.

• #1 Vesicovaginal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564389/

  Vesicovaginal fistula is an anomalous communication between the bladder and vagina, resulting in continuous urine leakage through the vagina. This condition occurs most commonly after obstetrical and gynecological injury. […] The etiology of this condition varies and can be categorized into congenital or acquired. Acquired vesicovaginal fistula can be further divided into obstetric surgical, malignant, radiation, and miscellaneous categories. Congenital vesicovaginal fistula is very rare and typically associated with other urogenital malformations. Vesicovaginal fistula occurs most commonly after obstetrical and gynecological injury. In the developed world, the most common cause of vesicovaginal fistula is gynecological surgery. In North America, bladder injury during a hysterectomy is the most common cause. In developing countries, obstructed labor and the resulting pressure necrosis are the most common causes of vesicovaginal fistulas. Poor socioeconomic status, malnourishment, low literacy rate, early marriage and childbearing, and inadequate obstetrical care are important risk factors for developing a vesicovaginal fistula in the developing world. […] Miscellaneous acquired causes of this condition include retroperitoneal, vascular, or pelvic surgery, urologic or gynecologic instrumentation, infectious and inflammatory diseases, sexual trauma, vaginal laser procedures, external violence, and vaginal foreign bodies.

• #1

  https://www.who.int/news-room/facts-in-pictures/detail/10-facts-on-obstetric-fistula

  Obstetric fistula is a hole in the birth canal caused by obstructed labour. […] It is a cause of maternal mortality and morbidity. […] Each year, between 50 000 to 100 000 women worldwide develop obstetric fistula. […] Women who experience this preventable condition suffer constant urinary incontinence which often leads to social isolation, skin infections, kidney disorders and even death if left untreated. […] Obstetric fistulae can largely be avoided by delaying the age of first pregnancy, by the cessation of harmful traditional practices and by timely access to quality obstetric care. […] Most fistulae occur among women living in poverty in cultures where a womans status and self-esteem may depend almost entirely on her marriage and ability to bear children. […] Patients with uncomplicated fistulae can undergo a simple surgery to repair the hole in their bladder or rectum. Approximately 80-95% of vaginal fistula can be closed surgically.

• #1 Vesicovaginal Fistula: Background, History of the Procedure, Problem

  https://emedicine.medscape.com/article/267943-overview

  Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF). […] This article reviews the etiology of VVF, the surgical principles of repair, and the techniques developed for their repair. […] In developing countries, the predominant cause of VVF is prolonged obstructed labor (97%). […] Numerous factors contribute to the development of VVF in developing countries. Commonly, these are areas where the culture encourages marriage and conception at a young age, often before full pelvic growth has been achieved. […] VVF in developed countries are attributed predominantly to inadvertent bladder injury during pelvic surgery (90%). […] Gynecologic procedures are the most common iatrogenic factor. […] Other types of pelvic surgery (eg, urologic, gastrointestinal surgery) also contribute to the incidence of VVFs; such surgeries include suburethral sling procedures, surgical repair of urethral diverticulum, electrocautery of bladder papilloma, and surgery for pelvic carcinomas. […] Risk factors that predispose to VVFs include prior pelvic or vaginal surgery, previous PID, ischemia, diabetes, arteriosclerosis, carcinoma, endometriosis, anatomic distortion by uterine myomas, and infection, particularly postoperative cuff abscess.

• #1 Rectovaginal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535350/

  RVF formation results as a complication of an underlying disease, injury, or surgical event. Diseases of the vagina or the pelvic organs can be complicated with a persistent connection between the rectum and vagina. The common causes of rectovaginal fistula are: Obstetric-related injury: This is the most common etiology of traumatic RVF, and probably for all RVFs. This includes third- and fourth-degree lacerations during vaginal delivery. […] Surgical procedure: Surgical interventions that cause unrecognized vaginal or rectal injury, insufficient tissue thickness between the two organs, or ischemia of the tissue may result in perforation and fistula formation through the damaged tissue. […] Diverticular disease: Complex diverticular disease is a common cause of fistula connecting to an intra-abdominal organ like the bladder and vagina. Erosion of the diverticular wall with inflammation and abscess can extend, involve, and erode the adjacent organ walls resulting in a fistulous connection.

• #1 Rectovaginal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535350/

  Crohn’s disease: Chronic inflammatory bowel diseases, especially Crohn’s disease, is a well-known cause of intestinal fistulization. […] Malignancy: Cancer of the intestine or adjacent organs is a known cause of bowel perforation and fistulization. RVF can result from vaginal, cervical, or, more commonly, rectal cancer that involves the entire wall thickness and extends to the adjacent vagina. […] Radiation: Radiation causes long-term chronic tissue inflammation with poor healing and repair processes. Therefore, fistulae caused by radiation manifest after a lag period from radiation exposure. […] Non-surgical injuries and foreign bodies: Injuries in trauma or a foreign body can result in a non-healing abnormal connection with the vagina.

• #1 Treatment for Vesicovaginal Fistula | University of Utah Health

  https://healthcare.utah.edu/urology/conditions/vesico-vaginal-fistula

  Vesicovaginal fistulas are usually a complication of gynecologic or urologic surgery. Any surgery on your pelvic area could lead to a fistula: […] Radiation to your pelvis can also cause a vesicovaginal fistula. Some people have radiation therapy to treat gynecologic cancer. Damage from radiation may get worse slowly and over a long period. So, vesicovaginal fistulas can develop many years after your radiation treatment. […] Prolonged labor during childbirth can cause vesicovaginal fistulas. However, this happens most often in areas without access to modern obstetric care. Prolonged labor rarely causes vesicovaginal fistulas in the United States. But, complications from C-section and difficult childbirth can still cause some fistulas.

• #1 Bowel Incontinence and Rectovaginal Fistula – Foundation for Female Health Awareness

  https://femalehealthawareness.org/en/bowel-incontinence-and-rectovaginal-fistula/

  Childbirth is a common cause of bowel incontinence. Stretching of the vagina with delivery of the baby can affect the anal sphincter complex. It can cause injury that results in difficulty controlling bowel movements. This can be experienced in the weeks and months after the child is born or even many years later. […] The most common cause is related to childbirth. During birth, there can be injury to the pelvic floor which can lead to tears in the vagina that need to be repaired. Even when these tears are correctly repaired, sometimes the healing process can be affected by infection or other issues that cause the repaired area to break down. This can lead to formation of a fistula. […] Infection not related to childbirth can also lead to fistula formation. An abscess, which is an infectious collection, can lead to the formation of a fistula if it forms near the vagina and rectum.

• #1 Rare causes of genital fistula in nine African countries: a retrospective review | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-02050-z

  Most genital fistulas result from prolonged, obstructed labor or surgical complications. Other causes include trauma (from accidents, traditional healers, or sexual violence), radiation, carcinoma, infection, unsafe abortion, and congenital malformation. […] Rare fistula accounted for 1.12% (76/6,787) of all fistulas, including traumatic accidents (19/6,787, 0.28%), traumatic sexual violence (15/6,787, 0.22%), traumatic injuries caused by traditional healers (13/6,787, 0.19%), unsafe abortion (10/6,791, 0.15%), radiation (8/6,787, 0.12%), complications of HIV infection (6/6,787, 0.09%), and congenital abnormality (5/6,787, 0.07%). […] Other genital fistula etiologies have been reported. FIGOs 2011 Fistula Surgery Training Manual cited traumatic causes (including [forceful] coitus, sexual violence, accidental trauma, and female genital mutilation), infection (including granulomatous tuberculosis, and HIV), malignancy (especially advanced cervical cancer), radiotherapy, and congenital malformations.

• #1 Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities

  https://www.mdpi.com/2077-0383/7/4/87

  Other risk factors include smoking, diabetes, obesity, and a previous history of irradiation. […] In the setting of pelvic malignancies, tumors may cause local tissue destruction resulting in fistula formation. Radiation can lead to fistula formation due to obliterative endarteritis and chronic ischemia. […] Another common cause of fistulas in the developed world is Crohn’s disease; up to 10% of those with Crohn’s disease will develop some type of fistula, with anovaginal and rectovaginal fistulas accounting for approximately 9% of these cases.

• #1 Obstetric fistula – Wikipedia

  https://en.wikipedia.org/wiki/Obstetric_fistula

  In the developed world, such as the US, the primary cause of obstetric fistulae, particularly rectovaginal fistulae, is the use of episiotomy and forceps. Primary risk factors include early or closely spaced pregnancies and lack of access to emergency obstetric care. […] Social, political, and economic causes that indirectly lead to the development of obstetric fistulae concern issues of poverty, malnutrition, lack of education, early marriage and childbirth, the role and status of women in developing countries, harmful traditional practices, sexual violence, and lack of good quality or accessible maternal and health care. […] Poverty is the main indirect cause of obstetric fistulae around the world. As obstructed labor and obstetric fistulae account for 8% of maternal deaths worldwide and „a 60-fold difference in gross national product per person shows up as a 120-fold difference in maternal mortality ratio,” impoverished countries produce higher maternal mortality rates and thus higher obstetric fistula rates.

• #1 Obstetric fistula – Wikipedia

  https://en.wikipedia.org/wiki/Obstetric_fistula

  One reason that poverty produces such high rates of fistula cases is the malnutrition that exists in such areas. Lack of money and access to proper nutrition, as well as vulnerability to diseases that exist in impoverished areas because of limited basic health care and disease prevention methods, cause inhabitants of these regions to experience stunted growth. […] High levels of poverty also lead to low levels of education among impoverished women concerning maternal health. This lack of information in combination with obstacles preventing rural women to easily travel to and from hospitals lead many to arrive at the birthing process without prenatal care. […] Early marriages lead to early childbirth, which increases the risk of obstructed labor, since young mothers who are poor and malnourished may have underdeveloped pelvises. In fact, obstructed labor is responsible for 76 to 97% of obstetric fistulae.

• #1 Fistulas – Urogynecology & Pelvic Health | UCLA Health

  https://www.uclahealth.org/medical-services/womens-pelvic-health/conditions-treated/fistulas

  In women, a fistula can occur as a result of prolonged childbirth, connecting the bladder and vagina, or the rectum and vagina. […] The most common cause of a connection between the vagina and the bladder in the United States is injury to the bladder during pelvic surgery, particularly hysterectomy. […] In developing countries, fistula are most commonly associated with prolonged labor. […] The World Health Organization has called fistulas „the single most dramatic aftermath of prolonged or neglected childbirth,” estimating that more than 2 million women live with fistulas worldwide. […] Urogenital and colorectal fistulas can also be caused by abortions; pelvic fractures; cancer or radiation therapy targeted at the pelvic area; abscess of the glands near the rectum; inflammatory bowel disease such as Crohn’s Disease and ulcerative colitis; and infected episiotomies after childbirth.

• #1 Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities

  https://www.mdpi.com/2077-0383/7/4/87

  Vaginal fistulas account for some of the most distressing symptoms seen by clinicians today. The etiology of vaginal fistulas includes obstetrical complications, inflammatory bowel disease, post-surgical causes, pelvic malignancies, trauma, infection, congenital conditions, and radiation effects. […] In developing countries, the prevalence of vaginal fistulas may be as high as 1 in 1000 women, and occur as a result of prolonged or obstructed labor. This is thought to be a result of tissue necrosis in the pelvis, caused by tissue entrapment between fetal parts and the bony pelvis. […] In industrialized countries, vaginal fistulas are more commonly iatrogenic, resulting from surgical intervention or radiation therapy. The most common iatrogenic cause is surgery following obstetric complications or gynecologic procedures, predominantly hysterectomies, with the most common type thought to be vesicovaginal fistulas.

• #1 Vesicovaginal Fistula: Etiology, Diagnosis, and Treatment

  https://www.urology-textbook.com/vesicovaginal-fistula.html

  Prolonged obstructed labor with pressure necrosis of the anterior vaginal wall and the bladder neck (this is the most common cause of a vesicovaginal fistula in developing countries). […] Hysterectomy (in 0.12%, depending on the indication for surgery) […] Gynecological tumors: infiltration, radiation therapy or surgical treatment. […] Trauma.

• #1 Vesicovaginal and Urethrovaginal Fistulas | GLOWM

  https://www.glowm.com/section-view/heading/Vesicovaginal%20and%20Urethrovaginal%20Fistulas/item/64

  The etiology of VVF at the time of hysterectomy is uncertain. Some are the result of an unrecognized bladder laceration at the time of dissecting the bladder off the cervix. […] Radiation-induced fistulas are commonly associated with treatment for carcinoma of the cervix or other pelvic malignancies. […] There are case reports of VVFs caused by vaginal foreign bodies, direct trauma from masturbation or automobile accidents, bladder calculi, forgotten vaginal pessaries, endometriosis, and infections such as tuberculosis, schistosomiasis, syphilis, and lymphogranuloma venereum, and from idiopathic congenital causes. […] Urethrovaginal fistulas may occur postpartum and are associated with operative vaginal delivery, after surgery for urethral diverticulum, anterior vaginal wall prolapse, or urinary incontinence, and after radiation therapy.

• #1 Vaginal Fistula Repair | Types, Causes, Symptoms and TreatmentsTikTok

  https://www.ibihealthcare.com/womens-health/vaginal-fistula/

  A vaginal fistula (passage or hole) is an abnormal tunnel between two organs. It is abnormal in that it should not exist and can create significant problems. In women, fistulas that involve the vagina and urinary tract can develop due to problems that arise during childbirth, injury, infection, and inflammation in the pelvic area. […] Several issues can be caused by each type of fistula that requires treatment. […] A vaginal fistula connects the vagina to another organ. This can include the bladder, colon, or rectum. […] This is the most common type of vaginal fistula. […] This is a type of vaginal fistula that occurs between your vagina and the urethra (the tube that removes urine from your body). […] This type of fistula is an opening between the vagina and the large intestine. […] This type of fistula occurs when there is an opening between your vagina and your ureters (the ducts that carry urine away from your kidneys). […] This is an opening between the vagina and the colon. […] This occurs when there is an opening between the small intestine and the vagina.

• #1 Rare causes of genital fistula in nine African countries: a retrospective review | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-02050-z

  Fistulas attributable to rare causes illuminate a variety of risks confronting women. […] Some rare causes involve a person directly doing something harmful to women’s bodies, including unsafe abortion, sexual violence, and treatments from traditional healers. […] Trauma caused by traditional healers was a particular problem among Somali women. […] Unsafe abortion or dilatation and curettage led to fistula development in 10 women, of whom four were in Kenya and three in Tanzania. […] Radiation therapy for cervical, endometrial, or multifocal cancer can induce fistula and decrease the elasticity of surrounding tissues. […] Fistulas caused by traditional healers may be combined with accidental cases that occur in health facilities. Trauma inflicted by traditional healers is clearly distinct from surgical complications, and separate counting will enable appropriately targeted responses. […] HIV infection can lead to fistula formation in rare cases.

• #2 Vaginal Fistula: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/womens/urogynecology/vaginal-fistula

  A fistula begins with a lack of blood supply to the vaginal tissue, which causes the tissue to weaken and die. The holes can take days or, in some cases, years to develop. The initial damage may be caused by traumatic injury, certain treatments, or disease in the area. […] Common causes of vaginal fistulas: […] Childbirth […] Cancer, including colon or cervical cancer […] Radiation for cancer treatments in the pelvic area […] Surgery on the rear wall of the vagina, anus, rectum, or perineum, including hysterectomies and C-sections […] Infections, such as diverticulitis […] Diseases, including inflammatory bowel disease (IBD), ulcerative colitis, and Crohns disease […] Traumatic injury.

• #2 Vaginal fistula | Altru Health System

  https://www.altru.org/health-library/conditions/vaginal-fistula

  Vaginal fistulas can form after childbirth or after an injury, a surgery, an infection or radiation treatment. […] Vaginal fistulas have many possible causes, including certain medical conditions and problems that can happen because of surgery. These causes include the following: […] Surgery complications. Surgeries that involve the vaginal wall, anus or rectum can lead to vaginal fistulas. […] Childbirth injuries. A vaginal fistula could stem from tearing that sometimes happens when a baby’s head comes through the opening of the vagina. […] Certain cancers and radiation therapy. Cancer of the anus, rectum, vagina or cervix can lead to a vaginal fistula. […] Diverticulitis. This condition involves small, bulging pouches in the digestive tract. Diverticulitis that leads to a vaginal fistula is more common in older people. […] A large amount of stool stuck in the rectum. This condition is known as a fecal impaction. It also is more likely to cause a vaginal fistula in an older person.

• #2 Vaginal Fistula: Types, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22079-vaginal-fistula

  Prolonged labor, trauma and pelvic surgeries can cause vaginal fistulas. […] A lack of blood supply to vaginal tissue causes the tissue to die or become damaged. A hole or fistula forms in the tissue where this damage occurs. These openings can develop in a few days or over several years. Rarely, a person is born with a vaginal fistula. […] Causes of vaginal fistulas include: Prolonged labor during childbirth. Vaginal tears during childbirth or an episiotomy. Abdominal or pelvic surgery, including C-sections and hysterectomies. Cancer in your pelvic area, like cervical cancer or colorectal (colon) cancer. Inflammatory bowel diseases (IBD) like Crohns disease and ulcerative colitis. Colon infections like diverticulitis. Radiation therapy to the pelvic region. Trauma or injury.

• #2 Fistulas | Symptoms & Treatment | CU Urogynecology | Denver, CO

  https://urogyn.coloradowomenshealth.com/conditions/colon-bowel/fistulas.html

  In women, a fistula can occur as a result of prolonged childbirth, connecting the bladder and vagina, or the rectum and vagina. […] Fistulas can form when the blood supply to the tissue is cut off, causing the tissue to disintegrate. […] The World Health Organization has called fistulas the single most dramatic aftermath of prolonged or neglected childbirth, estimating that more than 2 million women live with fistulas worldwide. In the developing world, the problem arises during prolonged labor (lasting up to three to five days), with the unborn child pressing against the mothers birth canal very tightly, cutting off blood flow to the tissues between the vagina and rectum and/or bladder. This causes the tissues to disintegrate and rot away, allowing an opening to form. […] Urogenital and colorectal fistulas can also be caused by abortions, pelvic fractures, cancer or radiation therapy targeted at the pelvic area, abscess of the glands near the rectum, inflammatory bowel disease such as Crohns Disease and ulcerative colitis, and infected episiotomies after childbirth. Sexual abuse and rape can also be a factor. The most common cause of a connection between the vagina and the bladder in the United States is injury during hysterectomy.

• #2 Vaginal Fistula | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/vaginal-fistula-tn10138

  A vaginal fistula starts with some kind of tissue damage. After days to years of tissue breakdown, a fistula opens up. […] A vaginal fistula sometimes happens after: […] Surgery of the back wall of the vagina, the perineum, anus, or rectum. Open hysterectomy is linked to most vesicovaginal tract fistulas. […] In areas without health care, vaginal fistulas are more common. After days of difficult labor, vaginal, bladder, or rectal damage can occur, sometimes causing fistulas.

• #2 Vaginal Fistula – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/tn10138

  A vaginal fistula starts with some kind of tissue damage. After days to years of tissue breakdown, a fistula opens up. […] A vaginal fistula sometimes happens after: Surgery of the back wall of the vagina, the perineum, anus, or rectum. Open hysterectomy is linked to most vesicovaginal tract fistulas. Radiation treatment for pelvic cancer. A period of inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) or diverticulitis. A deep tear in the perineum or an infected episiotomy after childbirth. […] In areas without health care, vaginal fistulas are more common. After days of difficult labor, vaginal, bladder, or rectal damage can occur, sometimes causing fistulas.

• #2 Vaginal fistula | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/vaginal-fistula?content_id=CON-20253618

  A vaginal fistula is an unusual opening that forms between the vagina and another organ, such as the bladder, colon or rectum. Vaginal fistulas can form after childbirth or after an injury, a surgery, an infection or radiation treatment. […] Vaginal fistulas have many possible causes, including certain medical conditions and problems that can happen because of surgery. These causes include the following: […] Surgery complications. Surgeries that involve the vaginal wall, anus or rectum can lead to vaginal fistulas. So can surgery on the area between the vagina and anus, called the perineum. Fistulas can form for reasons such as injuries during surgery and infections after surgery. […] Childbirth injuries. A vaginal fistula could stem from tearing that sometimes happens when a baby’s head comes through the opening of the vagina. Or a fistula might form due to an infection of a surgical cut made between the vagina and the anus to help deliver a baby.

• #2 Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities

  https://www.mdpi.com/2077-0383/7/4/87

  Other risk factors include smoking, diabetes, obesity, and a previous history of irradiation. […] In the setting of pelvic malignancies, tumors may cause local tissue destruction resulting in fistula formation. Radiation can lead to fistula formation due to obliterative endarteritis and chronic ischemia. […] Another common cause of fistulas in the developed world is Crohn’s disease; up to 10% of those with Crohn’s disease will develop some type of fistula, with anovaginal and rectovaginal fistulas accounting for approximately 9% of these cases.

• #2 Vesico-Vaginal Fistula – London Urology Specialists

  https://www.londonurologyspecialists.co.uk/vesico-vaginal-fistula/

  Vesico-vaginal fistulae are a common complication of childbirth in the developing world due to prolonged childbirth. This causes pressure on the pelvic floor and tissue necrosis (tissue death) of the back wall of the bladder and / or urethra (water-pipe). […] Nearly all vesico-vaginal fistulae occur because of surgical intervention. The vast majority in the UK occur following hysterectomy or Caesarean section, with an incidence rate of 0.3-2%. Other causes include: Delayed labour (childbirth) in developing countries, Hysterectomy, Emergency Caesarean section, Complex incontinence surgery, Radiotherapy for pelvic cancer, Infection. […] In cases where radiotherapy is involved fistulae may develop many years after the initial treatment.

• #2 Rectovaginal fistula – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectovaginal-fistula/symptoms-causes/syc-20377108

  A rectovaginal fistula may result from: […] A rectovaginal fistula may form as a result of: […] Injuries during childbirth. Delivery-related injuries are the most common cause of rectovaginal fistulas. […] Inflammatory bowel disease. The second most common cause of rectovaginal fistulas is Crohn’s disease and, more rarely, ulcerative colitis. […] Cancer or radiation treatment in the pelvic area. A cancerous tumor in your rectum, cervix, vagina, uterus or anal canal can result in a rectovaginal fistula. […] Surgery involving the vagina, perineum, rectum or anus. In rare cases, prior surgery in your lower pelvic area, such as removing an infected Bartholin’s gland, can cause a fistula to develop. […] Complication from diverticulitis. Infection of small, bulging pouches in your digestive tract, called diverticulitis, may cause the rectum or large intestine to stick to the vagina and may lead to a fistula. […] Other causes. Rarely, a rectovaginal fistula may develop following infections in the skin around the anus or vagina.

• #2 Rectovaginal Fistula: Causes, Symptoms And Treatment

  https://www.netmeds.com/health-library/post/rectovaginal-fistula-causes-symptoms-and-treatment?srsltid=AfmBOoqMmttBEck7dilnKM5yrwXvBdLC-km9EwwOnd4QT9XEYoQsXZgj

  In most cases, injury to the vaginal tissue stops the blood flow, resulting in the death of the particular tissue and creating a fistula. […] Some of the most common causes of a rectovaginal fistula include: Prolonged labour pain spreading for days: During a long or complicated delivery, the perineum layer can rupture, or the doctor might have to cut the perineum (episiotomy) to deliver the baby. […] Inflammatory bowel disease (IBD): Different types of IBD like Crohns disease and ulcerative colitis often cause inflammation in the digestive tract. These inflammatory conditions can often increase the risk of developing a fistula. […] Radiation to the pelvic region: Exposure to radiation therapy for treating cancer in the vagina, uterus, cervix, rectum, or anus can often cause a rectovaginal fistula. Even cancer of the above parts without radiation can also create a fistula.

• #2 Bowel Incontinence and Rectovaginal Fistula – Foundation for Female Health Awareness

  https://femalehealthawareness.org/en/bowel-incontinence-and-rectovaginal-fistula/

  Other causes of rectal fistulas include Crohns disease, prior surgery through the vagina such as a hysterectomy, prior surgery to the rectum such as a hemorrhoid repair, pelvic surgery, and chemotherapy or radiation therapy for cancer. […] There are many causes of fistula, including childbirth, infection, surgery, and Crohns disease.

• #2 Vesicovaginal Fistula | UC Irvine Health | Department of Urology

  https://www.urology.uci.edu/female_urology_vesicovaginal_fistula.shtml

  A vesicovaginal fistula occurs when a fistula (abnormal connection between two organs or between an organ and a body surface) connects the bladder to the vagina. […] In some cases, vesicovaginal fistulas (as well as other vaginal fistulas) are often caused by sexual trauma to a young woman or a difficult childbirth. However, vesicovaginal fistulas usually are the result of trauma from a medical procedure or disease. Here are some of the common causes: […] Pelvic surgery, such as a hysterectomy […] Cancer of the cervix, vagina or bladder […] Pelvic radiation for cancer […] Episiotomy or tear during childbirth […] Injury caused by an automobile accident or other serious accident.

• #2 Vesicovaginal Fistula: Symptoms, Diagnosis, and Treatment

  https://www.healthline.com/health/womens-health/vesicovaginal-fistula

  VVF can be congenital, meaning you were born with it. More often though, its acquired, meaning its a result of another medical event or injury. […] In many low and middle income countries, the most common cause of VVF thats acquired is prolonged or obstructed labor. Labor is considered obstructed when the fetus cant enter the birth canal even when uterine contractions are strong. When this happens, parts of the fetus such as the head or shoulder press against the pelvis and can cause injury to the tissues of the surrounding area. […] Additional causes can include: trauma during labor and delivery (such as assisted vaginal deliveries that involve instruments), infections and inflammatory diseases, foreign objects (such as pessaries), sexual trauma and violence, vaginal laser procedures.

• #2 Vesicovaginal fistula | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vesicovaginal-fistula-2?lang=us

  Vesicovaginal fistulas are abnormal fistulous connections between the urinary bladder and vagina, resulting in an involuntary discharge of urine through the vagina. […] There are a number of causes, including prolonged obstructed labor (most common in developing countries), surgery, e.g. hysterectomy (most common in developed countries), pelvic malignancy (e.g. bladder carcinoma, endometrial carcinoma), radiotherapy, uterine rupture. […] Other risk factors include trauma, pelvic inflammatory disease and diabetes.

• #2 Obstetric fistula – Wikipedia

  https://en.wikipedia.org/wiki/Obstetric_fistula

  In the developed world, such as the US, the primary cause of obstetric fistulae, particularly rectovaginal fistulae, is the use of episiotomy and forceps. Primary risk factors include early or closely spaced pregnancies and lack of access to emergency obstetric care. […] Social, political, and economic causes that indirectly lead to the development of obstetric fistulae concern issues of poverty, malnutrition, lack of education, early marriage and childbirth, the role and status of women in developing countries, harmful traditional practices, sexual violence, and lack of good quality or accessible maternal and health care. […] Poverty is the main indirect cause of obstetric fistulae around the world. As obstructed labor and obstetric fistulae account for 8% of maternal deaths worldwide and „a 60-fold difference in gross national product per person shows up as a 120-fold difference in maternal mortality ratio,” impoverished countries produce higher maternal mortality rates and thus higher obstetric fistula rates.

• #2

  https://www.who.int/news-room/facts-in-pictures/detail/10-facts-on-obstetric-fistula

  Obstetric fistula is a hole in the birth canal caused by obstructed labour. […] It is a cause of maternal mortality and morbidity. […] Each year, between 50 000 to 100 000 women worldwide develop obstetric fistula. […] Women who experience this preventable condition suffer constant urinary incontinence which often leads to social isolation, skin infections, kidney disorders and even death if left untreated. […] Obstetric fistulae can largely be avoided by delaying the age of first pregnancy, by the cessation of harmful traditional practices and by timely access to quality obstetric care. […] Most fistulae occur among women living in poverty in cultures where a womans status and self-esteem may depend almost entirely on her marriage and ability to bear children. […] Patients with uncomplicated fistulae can undergo a simple surgery to repair the hole in their bladder or rectum. Approximately 80-95% of vaginal fistula can be closed surgically.

• #2 Obstetric fistula – Wikipedia

  https://en.wikipedia.org/wiki/Obstetric_fistula

  Even women who do make it to the hospital may not get proper treatment. Countries that suffer from poverty, civil and political unrest or conflict, and other dangerous public health issues such as malaria, HIV/AIDS, and tuberculosis often suffer from a severe burden and breakdown within the healthcare system.

• #2 Vaginal Fistulas | Pioneer Valley Urology | | Springfield, MA | Palmer, MA | Enf

  https://www.pvurology.org/vaginal-fistulas.php

  Vaginal fistulas may occur after childbirth, surgery in the region, radiation treatment, or inflammatory bowel disease. […] Vaginal fistulas are more common in women who have limited access to health care and, therefore, much more prevalent in underdeveloped countries. […] In locations where women give birth without being monitored or assisted, severe vaginal tears that lead to fistulas occur more frequently. […] Even in areas where good health care is readily available, women may develop vaginal fistulas after one of the following: Surgery of the vagina, perineum, anus, or rectum; Radiation therapy for pelvic cancer; Acute episodes of inflammatory bowel disease; Deep tears during childbirth; Infected episiotomy incisions. […] Most vaginal fistulas affecting the urinary tract are associated with open hysterectomy procedures.

• #2 Vesicovaginal Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564389/

  Vesicovaginal fistula is an anomalous communication between the bladder and vagina, resulting in continuous urine leakage through the vagina. This condition occurs most commonly after obstetrical and gynecological injury. […] The etiology of this condition varies and can be categorized into congenital or acquired. Acquired vesicovaginal fistula can be further divided into obstetric surgical, malignant, radiation, and miscellaneous categories. Congenital vesicovaginal fistula is very rare and typically associated with other urogenital malformations. Vesicovaginal fistula occurs most commonly after obstetrical and gynecological injury. In the developed world, the most common cause of vesicovaginal fistula is gynecological surgery. In North America, bladder injury during a hysterectomy is the most common cause. In developing countries, obstructed labor and the resulting pressure necrosis are the most common causes of vesicovaginal fistulas. Poor socioeconomic status, malnourishment, low literacy rate, early marriage and childbearing, and inadequate obstetrical care are important risk factors for developing a vesicovaginal fistula in the developing world. […] Miscellaneous acquired causes of this condition include retroperitoneal, vascular, or pelvic surgery, urologic or gynecologic instrumentation, infectious and inflammatory diseases, sexual trauma, vaginal laser procedures, external violence, and vaginal foreign bodies.

• #2 Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities

  https://www.mdpi.com/2077-0383/7/4/87

  Vaginal fistulas account for some of the most distressing symptoms seen by clinicians today. The etiology of vaginal fistulas includes obstetrical complications, inflammatory bowel disease, post-surgical causes, pelvic malignancies, trauma, infection, congenital conditions, and radiation effects. […] In developing countries, the prevalence of vaginal fistulas may be as high as 1 in 1000 women, and occur as a result of prolonged or obstructed labor. This is thought to be a result of tissue necrosis in the pelvis, caused by tissue entrapment between fetal parts and the bony pelvis. […] In industrialized countries, vaginal fistulas are more commonly iatrogenic, resulting from surgical intervention or radiation therapy. The most common iatrogenic cause is surgery following obstetric complications or gynecologic procedures, predominantly hysterectomies, with the most common type thought to be vesicovaginal fistulas.

• #2 Obstetric Fistula – Causes, Symptoms, Diagnosis, Treatment, Prevention, Health Tips

  https://www.medindia.net/health/conditions/obstetric-fistula.htm

  Obstetric fistula, or vaginal fistula, is an abnormal communication between the vagina and either the bladder anteriorly or the lower digestive tract posteriorly. It is a complication of childbirth and occurs due to prolonged childbirth. […] Obstetric fistula is usually a problem of underdeveloped countries and is commonly caused to due prolonged, unattended labor. Other possible causes of vaginal fistula include poorly performed abortions, use of episiotomy and forceps during labor, pelvic fracture, resulting in a difficult labor, cervical cancer therapy with radiation, inflammatory bowel disease like ulcerative colitis, Crohns disease, sexual abuse or rape, and trauma during surgery of vagina, perineum, anus or rectum. […] There are several indirect risk factors that can end up in causing the obstetric fistula. Poverty, malnutrition, lack of information, early marriages and childbirth, and the status of women in under-developed and developing countries are significant contributors to the risk of developing obstetric fistula.

• #2 Vesicovaginal Fistula

  https://gamalghoniemmd.com/conditions/vesicovaginal-fistula/

  Although a vesicovaginal fistula can lead to serious complications, such as allowing urine to evacuate from the vagina, modern medical treatments can restore normal function. […] A vesicovaginal fistula (VVF) describes the creation of a passageway between the vagina and bladder. While this medical condition may seem rare, its commonly associated with complications from childbirth. […] VVF occurs when the mothers pelvic region is too narrow to accommodate the babys head. […] The formation of vesicovaginal fistula is related to trauma within the pelvic region. Prolonged or obstructed labor is a common cause of VVF. However, a fistula between the vagina and bladder may occur outside of the realm of childbirth. […] Some of the more common causes of vesicovaginal fistula is trauma to the bladder during a medical procedure, such as pelvic surgery, urologic examination/surgery, gynecologic examination/surgery, and episiotomy during labor.

• #2 Rectovaginal Fistula: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/193277-overview

  The most common etiology for RVF of traumatic origin, and probably for all RVFs, is obstetric injury. […] Other etiologies for RVF include the following: Radiation injury, Inflammatory bowel disease (IBD), most often Crohn disease, Operative trauma, Infectious etiologies, Neoplasm.

• #2 Rectovaginal Fistula – Your Pelvic Floor

  https://www.yourpelvicfloor.org/conditions/rectovaginal-fistula/

  The majority of rectovaginal fistulas are caused by childbirth injury. Trauma related to operative vaginal deliveries such as forceps and vacuum deliveries, as well as third- and fourth-degree tears, increases the risk for rectovaginal fistulas to develop. Rectovaginal fistulas can also develop following radiation to the pelvis or in women with inflammatory bowel disease. There are rare cases of congenital rectovaginal fistulas. […] Risk factors for development of rectovaginal fistula include: Obstetric trauma, Inflammatory bowel disease, Gynecologic or colorectal surgery, Perianal infections, Radiation to pelvis, Malignancy, Violent trauma, Congenital anorectal anomalies.

• #2 What Is Vesicovaginal and Ureterovaginal Fistula?

  https://www.icliniq.com/articles/womens-health/vesicovaginal-and-ureterovaginal-fistula

  The most common cause of fistula include: […] Complicated childbirth. […] Abdominal surgery like hysterectomy or cesarean section. […] Radiational therapy. […] Traumatic injuries during surgical procedures. […] Pelvic, colon, or cervical cancer. […] Bowel diseases like diverticulitis or Crohns disease. […] Infections and inflammation to the urinary bladder, vagina, and cervix. […] Traumatic injury, for instance, falls on sharp objects or accidents. […] Congenital conditions. […] Foreign bodies like neglected pessaries (a device that can be inserted into the vagina to support its internal structure).

• #2 Vesicovaginal and Urethrovaginal Fistulas | GLOWM

  https://www.glowm.com/section-view/heading/Vesicovaginal%20and%20Urethrovaginal%20Fistulas/item/64

  The majority of the literature reflects a particular centers experience. Lee and colleagues found 82% of their institutions fistulas to have resulted from gynecologic surgery, 8% from obstetric procedures, 6% from pelvic radiotherapy, and 4% from trauma. […] Predisposing risk factors for VVF include a history of pelvic irradiation, cesarean section, endometriosis, prior pelvic surgery or pelvic inflammatory disease, diabetes mellitus, concurrent infection, vasculopathies, and tobacco abuse. In developing countries, obstetric trauma remains the leading cause of VVFs. […] Obstructed labor is a common complication of childbirth and may lead to obstetric vesicovaginal fistula which are uniquely human. […] In countries with modern obstetric care, VVF is most commonly associated with pelvic surgery. The majority of VVFs are related to procedures performed by obstetrician-gynecologists; particularly total abdominal hysterectomy.

• #2 Female Genital Fistula | Article | GLOWM

  https://www.glowm.com/article/heading/vol-7–fistula–female-genital-fistula/id/418273

  Obstructed labor is defined when the fetal head can no longer descent through the birth canal irrespective of adequate uterine contractions. The maternal soft tissues (bladder, vagina, cervix, rectum) become compressed between the boney plates of the fetal head and the maternal pelvic bones leading to prolonged pressure on blood vessels causing ischemic necrosis. […] Most post-hysterectomy fistulas are small and are located at the vaginal cuff where the bladder was dissected off the lower uterine segment and cervix. A small proportion of vesicovaginal fistulas in sub-Saharan Africa result from surgical complications usually associated with hysterectomy. […] In some countries, a small number of obstetric fistulas result from injuries associated with traditional medical practices such as female genital mutilation or „salt packing”. Economic, societal, and cultural factors contribute to the circumstances in which injuries result in the obstetric fistula. […] The most crucial factor in preventing genital fistula formation is the provision of competent maternal care with improved access to emergency obstetric services.

• #3 Vaginal Fistula – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/tn10138

  A vaginal fistula starts with some kind of tissue damage. After days to years of tissue breakdown, a fistula opens up. […] A vaginal fistula sometimes happens after: Surgery of the back wall of the vagina, the perineum, anus, or rectum. Open hysterectomy is linked to most vesicovaginal tract fistulas. Radiation treatment for pelvic cancer. A period of inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) or diverticulitis. A deep tear in the perineum or an infected episiotomy after childbirth. […] In areas without health care, vaginal fistulas are more common. After days of difficult labor, vaginal, bladder, or rectal damage can occur, sometimes causing fistulas.

• #3 Obstetric fistula – Wikipedia

  https://en.wikipedia.org/wiki/Obstetric_fistula

  Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, ureter, or bladder. It can result in incontinence of urine or feces. Complications may include depression, infertility, and social isolation. […] Risk factors include obstructed labor, poor access to medical care, malnutrition, and teenage pregnancy. The underlying mechanism is poor blood flow to the affected area for a prolonged period of time. […] Obstetric fistulae can also be caused by poorly performed abortions, and pelvic fracture, cancer, or radiation therapy targeted at the pelvic area, inflammatory bowel disease (such as Crohn’s disease and ulcerative colitis). Other potential causes for the development of obstetric fistulae are sexual abuse and rape, especially in conflict/postconflict areas, and other trauma, such as surgical trauma.

• #3 Vesicovaginal and Urethrovaginal Fistulas | GLOWM

  https://www.glowm.com/section-view/heading/Vesicovaginal%20and%20Urethrovaginal%20Fistulas/item/64

  The majority of the literature reflects a particular centers experience. Lee and colleagues found 82% of their institutions fistulas to have resulted from gynecologic surgery, 8% from obstetric procedures, 6% from pelvic radiotherapy, and 4% from trauma. […] Predisposing risk factors for VVF include a history of pelvic irradiation, cesarean section, endometriosis, prior pelvic surgery or pelvic inflammatory disease, diabetes mellitus, concurrent infection, vasculopathies, and tobacco abuse. In developing countries, obstetric trauma remains the leading cause of VVFs. […] Obstructed labor is a common complication of childbirth and may lead to obstetric vesicovaginal fistula which are uniquely human. […] In countries with modern obstetric care, VVF is most commonly associated with pelvic surgery. The majority of VVFs are related to procedures performed by obstetrician-gynecologists; particularly total abdominal hysterectomy.

• #3 Rare causes of genital fistula in nine African countries: a retrospective review | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-02050-z

  Fistulas attributable to rare causes illuminate a variety of risks confronting women. […] Some rare causes involve a person directly doing something harmful to women’s bodies, including unsafe abortion, sexual violence, and treatments from traditional healers. […] Trauma caused by traditional healers was a particular problem among Somali women. […] Unsafe abortion or dilatation and curettage led to fistula development in 10 women, of whom four were in Kenya and three in Tanzania. […] Radiation therapy for cervical, endometrial, or multifocal cancer can induce fistula and decrease the elasticity of surrounding tissues. […] Fistulas caused by traditional healers may be combined with accidental cases that occur in health facilities. Trauma inflicted by traditional healers is clearly distinct from surgical complications, and separate counting will enable appropriately targeted responses. […] HIV infection can lead to fistula formation in rare cases.

• #3 Fistulas | Symptoms & Treatment | CU Urogynecology | Denver, CO

  https://urogyn.coloradowomenshealth.com/conditions/colon-bowel/fistulas.html

  In women, a fistula can occur as a result of prolonged childbirth, connecting the bladder and vagina, or the rectum and vagina. […] Fistulas can form when the blood supply to the tissue is cut off, causing the tissue to disintegrate. […] The World Health Organization has called fistulas the single most dramatic aftermath of prolonged or neglected childbirth, estimating that more than 2 million women live with fistulas worldwide. In the developing world, the problem arises during prolonged labor (lasting up to three to five days), with the unborn child pressing against the mothers birth canal very tightly, cutting off blood flow to the tissues between the vagina and rectum and/or bladder. This causes the tissues to disintegrate and rot away, allowing an opening to form. […] Urogenital and colorectal fistulas can also be caused by abortions, pelvic fractures, cancer or radiation therapy targeted at the pelvic area, abscess of the glands near the rectum, inflammatory bowel disease such as Crohns Disease and ulcerative colitis, and infected episiotomies after childbirth. Sexual abuse and rape can also be a factor. The most common cause of a connection between the vagina and the bladder in the United States is injury during hysterectomy.

• #3 Female Genital Fistula | Article | GLOWM

  https://www.glowm.com/article/heading/vol-7–fistula–female-genital-fistula/id/418273

  Obstructed labor is defined when the fetal head can no longer descent through the birth canal irrespective of adequate uterine contractions. The maternal soft tissues (bladder, vagina, cervix, rectum) become compressed between the boney plates of the fetal head and the maternal pelvic bones leading to prolonged pressure on blood vessels causing ischemic necrosis. […] Most post-hysterectomy fistulas are small and are located at the vaginal cuff where the bladder was dissected off the lower uterine segment and cervix. A small proportion of vesicovaginal fistulas in sub-Saharan Africa result from surgical complications usually associated with hysterectomy. […] In some countries, a small number of obstetric fistulas result from injuries associated with traditional medical practices such as female genital mutilation or „salt packing”. Economic, societal, and cultural factors contribute to the circumstances in which injuries result in the obstetric fistula. […] The most crucial factor in preventing genital fistula formation is the provision of competent maternal care with improved access to emergency obstetric services.

• #3 Female Genital Fistula | Article | GLOWM

  https://www.glowm.com/article/heading/vol-7–fistula–female-genital-fistula/id/418273

  Genital fistulas are abnormal communications between the female genital tract and bladder, ureters, urethra, or bowel. The incidence and etiology of fistulae vary geographically and remain a serious, debilitating condition for women worldwide. Obstetric vesicovaginal fistulae (VVFs) are predominantly caused by unrelieved obstructed labor. Recto-vaginal fistulae (RVFs) are rarely seen in isolation, though they may coexist with VVFs in more severe cases of obstructed labor. Combined fistulae occur in 510% of cases. […] In resource-limited countries, obstructed labor is the most common etiology of vesicovaginal fistulas. A significant factor in the development of fistulas is injuries resulting from traditional practices such as female genital mutilation. Further, sexual violence and the accessibility and quality of health care are paramount socio-economic determinants.

• #3 Vaginal fistula: Know all about causes, signs and treatment | HealthShots

  https://www.healthshots.com/preventive-care/reproductive-care/vaginal-fistula-know-all-about-causes-signs-and-treatment/

  More than 50,000 women worldwide develop a vaginal fistula every year, according to the World Health Organization (WHO). […] Varied reasons can cause damage to tissue in your vaginal wall and lead to the formation of a hole where it doesnt belong. […] The main culprit of vaginal fistulas is tissue damage to the vaginal walls. Some of the most commonly studied causes of vaginal tissue damage are: * Vaginal tearing or prolonged labour during childbirth * Pelvic or abdominal surgeries like hysterectomy or C-section * Cervical, pelvic, or colon cancer * Inflammatory bowel diseases (IBD) like ulcerative colitis and Crohns disease * Traumatic injury, such as a car accident * Radiation treatment.

• #3 What to Know About Vaginal, Anal and Other Fistulas | Banner

  https://www.bannerhealth.com/healthcareblog/better-me/what-to-know-about-fistulas

  Fistulas are not very common in developed countries like the U.S., but they can occur for various reasons. About 35% to 50% of adults with Crohns disease will develop one at some point. […] Fistulas form when sores caused by inflammation inside the body worsen to the point that they form a tunnel in internal tissues. These can occur after some type of injury to an organ, such as a complication from surgery, an injury or trauma or radiation therapy. They can sometimes occur as a result of having inflammatory bowel disease (IBD) like Crohns disease or ulcerative colitis. […] In developed countries like the U.S., most fistulas are iatrogenic, meaning they are caused by complications from surgery or radiation therapy. In most of these cases, you and your provider should be aware if you develop drainage that is unusual or any of the other symptoms described above.

• #3

  https://www.who.int/news-room/facts-in-pictures/detail/10-facts-on-obstetric-fistula

  Obstetric fistula is a hole in the birth canal caused by obstructed labour. […] It is a cause of maternal mortality and morbidity. […] Each year, between 50 000 to 100 000 women worldwide develop obstetric fistula. […] Women who experience this preventable condition suffer constant urinary incontinence which often leads to social isolation, skin infections, kidney disorders and even death if left untreated. […] Obstetric fistulae can largely be avoided by delaying the age of first pregnancy, by the cessation of harmful traditional practices and by timely access to quality obstetric care. […] Most fistulae occur among women living in poverty in cultures where a womans status and self-esteem may depend almost entirely on her marriage and ability to bear children. […] Patients with uncomplicated fistulae can undergo a simple surgery to repair the hole in their bladder or rectum. Approximately 80-95% of vaginal fistula can be closed surgically.

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