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There is an uneven distribution of specialized health care providers due to the below optimal training and supervision of health works and the low wages of fistula surgeons. [33] Most fistula surgeons come from developed countries and are brought to developing countries, the nations more often affected by fistula, by a variety of organizations.
Rectovaginal fistulas are often the result of trauma during childbirth (in which case it is known as obstetric fistula), with increased risk associated with significant lacerations or interventions are used such as episiotomy or operative (forceps/vacuum extraction) deliveries [2] or in situations where there is inadequate health care, such as in some developing countries.
Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. [citation needed] In addition to the medical sequela from these fistulas, they often have a profound effect on the patient's emotional well-being.
A ureterovaginal fistula is a result of trauma, infection, pelvic surgery, radiation treatment and therapy, malignancy, or inflammatory bowel disease. Symptoms can be troubling for women especially since some clinicians delay treatment until inflammation is reduced and stronger tissue has formed. [2]
The diagnosis of a rectovestibular fistula can be made in female newborns if the vulva is stained with meconium (the earliest form of stool in an infant). [3] The opening of the anus may be difficult to see due to its small size and position, but it may be visible as a thickening of the median perineal raphe with an obvious anal dimple.
An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. [2] Anal fistulae commonly occur in people with a history of anal abscesses. They can form when anal abscesses do not heal properly. [3]
A urethrovaginal fistula is an abnormal passageway that may occur the urethra and the vagina. [1] It is a sub-set of vaginal fistulas. [2] [3] It results in urinary incontinence as urine continually leaves the vagina. It can occur as an obstetrical complication, catheter insertion injury or a surgical injury. [4] [5]
In anatomy, a fistula (pl.: fistulas or fistulae /-l i,-l aɪ /; from Latin fistula, "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs to each other, often resulting in an abnormal flow of fluid from one space to the other.