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Colovaginal Fistula

A vaginal fistula is an abnormal opening in the vagina that allows stool or urine to pass through the vagina. A colovaginal fistula means the opening is between the vagina and the colon. It is a relatively uncommon occurrence.

Causes

Colovaginal fistulas can result from an injury, trauma from childbirth, surgery, inflammatory conditions such as diverticulitis or Crohn’s disease, infection, or cancer or radiation treatment in the pelvic area. They most commonly occur among women who have undergone a total hysterectomy. When the uterus is removed, inflammatory conditions in the pelvis can find a weak point at the vaginal cuff, and a fistula can form.

Symptoms

Symptoms consist of passage of fecal matter or gas through the vagina. A small hole permits passage of air. A larger fistula can cause liquid or even solid stool to pass. Other symptoms include:

  • Foul-smelling vaginal discharge
  • Recurrent vaginal or urinary tract infections
  • Pain during sexual intercourse
  • Abdominal pain or pain in the vagina
  • Fever
  • Nausea or vomiting
  • Sepsis and even death

Diagnosis 

Diagnosis is determined by patient history plus a physical exam. A CT with contrast or endoscopy can help diagnose small fistulae.

Treatment

A colovaginal fistula may need to be surgically closed to restore normal function. The size and location impact the treatment protocol. If diverticular disease has caused the fistula, a sigmoid colectomy may need to be done.

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Gladstone Office

6060 North Oak Trafficway
Suite 101
Gladstone, MO 64118
Phone: (816) 941-0800

Leawood Office

4370 W 109th St.
#350
Overland Park, KS 66211
Phone: (816) 941-0800

Overland Park Office

10100 W 87th St.
Suite 200
Overland Park, KS 66212
Phone: (816) 941-0800

Independence Office

19550 E 39th St
Suite 320
Independence, MO 64057
Phone: (816) 941-0800

Lee’s Summit

1980 SE Blue Parkway
Suite 2330
Lee’s Summit, MO 64063
Phone: (816) 941-0800