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Fistulas of the vagina are abnormal connections between the vagina and another organ. 

  • Rectum (recto)

  • Ileal pouch (pouch)

  • Colon (colo)

  • Small bowel (entero)

  • Anal canal (ano) 

Causes of fistulas include:

  • Injury during childbirth

  • Bowel disease

  • X-ray treatments

  • Cancer

  • Infection

  • Prior colorectal surgery

You may have gas or stool coming through the vagina. Based on the location, the repair may be done through the abdomen, vagina, or rectum. In a rectal approach repair, rectal tissue and/or muscle are moved to cover the fistula opening. If you have an anal-muscle defect, this may also be repaired. Repair of a complex fistula may need a short-term ostomy to help it heal. We will tell you how your fistula will be closed. 

Risks

Risks of repair include:

  • Infection

  • Bleeding (rare)

  • Breakdown of the stitches and nearby tissue

If there is a problem with the anal muscles or nerves, you may need these tests:

  • Anal ultrasound which allows the doctor to see the muscles and look for problems.

  • Manometry which measures resting and squeeze pressures in the anal canal.

  • Nerve tests which check how the nerves and muscles work together. 

  • Barium enema which may help find the fistula opening.

  • An exam with a scope of the large bowel and anal canal to help find the fistula.

  • We will tell you if you need a bowel prep before a test.

Getting Ready for Surgery 

You will need to do a bowel prep before your surgery. We will give you instructions to follow for the bowel prep. 

After Surgery

You may have bloody drainage from the vagina. Wear a pad to manage and check the output. Foul smelling drainage or soaking a pad with blood is not normal. If you have a short-term ostomy to help you heal, we will teach you how to take care of it. 

Pain

It is normal to have pain or pressure where the repair was made. We will prescribe pain pills for pain. 

Activity

  • Avoid all tobacco, including second hand smoke. 

  • It is okay to shower.

  • Check for a fever at the same time each day until your follow-up visit.

  • Walk every day. Nothing more strenuous than walking until okayed by your doctor. 

  • Your doctor will tell you when it is safe to have sex. 

  • Do not lift more than 10 pounds until okayed by your doctor.

  • Do not drive while taking narcotic pain pills.

Diet

Plan to eat a low fiber diet for 2 weeks after you go home. To avoid constipation, you need to take a stool softener. Expect to have loose stools while on the low fiber diet. 

When to Call 

  • Excess swelling

  • Excess bleeding

  • Foul smelling drainage

  • Pain not controlled with pain pills

  • Problems with bowel movements

  • Problems passing urine

  • Fever over 100.4°F by mouth for two readings, taken 4 hours apart

  • Any other questions for concerns

Who to Call

Digestive Health Center: (608) 242-2800.

After hours, weekends or holidays ask for the doctor on call for_________________. Leave your name and phone number with area code. We will call you back.

The toll-free number is: (855) 342-9900.