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Treatment, in the form of surgery, is considered essential to allow drainage and prevent infection. Repair of the fistula itself is considered an elective procedure which many patients opt for due to the discomfort and inconvenience associated with an actively draining fistula. [5] [3]
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.
The physical symptoms depend upon the location of the fistula. The most direct consequence of an obstetric fistula is the constant leakage of urine, feces, and blood as a result of a hole that forms between the vagina and bladder or rectum. [20] This leaking has both physical and societal penalties.
The median time to definitive repair from fistula onset was 6 months (range 1 day to 28 months). The 6-month time course is commonly utilized by groups with significant experience treating fistulas, owing to the trend in encountering a less hostile abdomen than in the early phases. [ 4 ]
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]
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.
An oroantral fistula (OAF) is an epithelialized oroantral communication (OAC), which refers to an abnormal connection between the oral cavity and the antrum. [1] The creation of an OAC is most commonly due to the extraction of a maxillary tooth (typically a maxillary first molar) which is closely related to the antral floor.
The fistula can communicate with the mouth (usually causing no symptoms), the paranasal sinuses (giving rhinorrhea) [1] or the facial skin (causing saliva to drain onto the skin). The usual cause is trauma, however salivary fistula can occur as a complication of surgery, or if the duct becomes obstructed with a calculus .