THE FISTULA NIGHTMARE

             story by Lilian Nansubuga

A vaginal fistula is an abnormal opening that connects your vagina to another organ. For example, a vaginal fistula can link your vagina to your:

• Bladder
• Ureters, the tubes that carry your pee from your kidneys to your bladder
• Urethra, the tube that carries your pee down from your bladder and outside your body
• Rectum, the lower part of your large intestine
• Large intestine
• Small intestine

A lady leaking due to vaginal fistula. 

Vaginal fistulas can be upsetting and embarrassing because they leak and cause bad smells. But they can also cause complications, like:

• Vaginal or urinary tract infections that keep coming back
• Hygiene problems
• Stool or gas that leaks through the vagina
• Irritated or inflamed skin around your vagina or anus
• An abscess — a swollen clump of infected tissue with pus that could be life-threatening if it’s not treated
• Fistulas that come back

Women who have Crohn’s disease and develop a fistula have a high risk of getting complications, such as fistulas forming again later or fistulas that don’t properly heal.

Fistulas develop when an organ becomes inflamed or injured. In most cases fistulas develop when there is massive pressure imposed on the joints .The most common location for a fistula is around the anus. These are called perianal fistulas. Over half of fistulas form in this location. The second most common location is between 2 loops of intestine. Fistulas can also form between the:

• rectum and vagina
• intestine and skin and intestine and bladder

 

What are symptoms of fistula?

Symptoms of a fistula depend on where the connection has formed. Fluid or waste may leak continually from the anus or vagina or seep through the wall of the abdomen.

If you have a perianal fistula, you may have ongoing rectal pain or swelling. A fistula between the intestine and bladder can cause a urinary tract infection that keeps returning. Fistulas between 2 loops of the intestine may not cause any symptoms.

What Causes It?

Just inside your anus are several glands that make fluid. Sometimes, they get blocked or clogged. When that happens, a bacteria buildup can create a swollen pocket of infected tissue and liquid. Doctors call this an abscess.

If you don’t treat the abscess, it’ll grow. Eventually, it’ll make its way to the outside and punch a hole in the skin somewhere near your anus.

Fistulas can form in the digestive tract or perianal region after surgery, radiation therapy for cancer, or traumatic injury. Some diseases and infections can cause fistulas, such as diverticulitis, sexually transmitted disease, and tuberculosis.

Another cause of fistula is early pregnancies in young teenage girls. With early pregnancies the bones have not yet matured enough to be strong to hold a baby. There tends to be complications during the delivery and in the end a fistula is developed.

Unsafe abortions also may lead to a fistula called vescicoviginal fistula.

 

How to prevent fistulas

Avoid early pregnancies as the body still has to develop to be able to carry a baby.

Unsafe abortions should be avoided and practice safe abortions.

Family planning allows couples to delay early births, space desired births, and limit family size. Up to one-third of all maternal deaths and injuries could have been prevented if women had access to contraception. Family planning can also help women with a repaired fistula achieve a successful pregnancy, if that is their desire; by helping them delay a future pregnancy until they are fully healed. Women who have experienced repair are generally advised to abstain from sexual relations for a period of time to allow them to heal. In some situations, for some women find it difficult to comply with this recommendation. Other women may need a longer time before they are able to successfully sustain a pregnancy, and family planning methods can help couples determine when the best time to get pregnant is.

Timely Cesarean section is critical for women with obstructed labor. doctors performing a cesarean delivery must be competent so that they do not inadvertently create an iatrogenic fistula. fistula care plus works with hospitals to ensure that quality cesarean sections are available from trained health professionals.

What’s the Treatment?

Some fistulas may heal on their own. If it’s a small bladder fistula, your doctor might want to try putting a small tube called a catheter into your bladder to drain the pee and give the fistula time to heal by itself.

He might also want to try special glue or plug made of natural protein to seal or fill the fistula. Still, many people need surgery. What kind of surgery you get depends on the type of fistula and where it is. It could be laparoscopic, where your doctor makes small cuts (incisions) and uses cameras and tools. Or it could be abdominal surgery, where you get a regular incision with a tool called a scalpel.

For a vaginal fistula that connects to your rectum, your doctor might:

• Sew a special patch over the fistula
• Take tissue from your body to close the fistula
• Fold a flap of healthy tissue over the fistula
• Fix the muscles of your anus if they are damaged

Your doctor will likely also prescribe an antibiotic to treat infection caused by the fistula.

fistula is real and we need to be cautious about our health.