Fistula Repairs of the Vagina

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

Causes of fistulas include:

• Injury during childbirth

• Bowel disease

• X-ray treatments

• Cancer

• Infection

• Prior colorectal surgery
  

Testing

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

• Anal ultrasound 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.
  

Fistula Repair

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.

Risks

Risks of repair include:

• Infection

• Bleeding (rare)

• Breakdown of the stitches and nearby tissue
  

After Surgery

You may have bloody drainage from the vagina. Wear a pad to manage and check the output. 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 encourage you to take over the counter pain reliefers such as Tylenol. We may prescribe pain pills for you

Activity

• Avoid all tobacco and secondhand smoke.

• It is okay to shower. Depending on the type of repair you may be able to, and encouraged to take baths

• 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

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

• Severe swelling

• Heavy bleeding

• Foul smelling drainage

• Pain not controlled with pain pills

• Problems with bowel movements

• Problems passing urine

• Fever over 100.4F

• Fully soaking a pad with blood or passing blood clots

• Any other questions for concerns
  

Who to Call

Digestive Health Center:
(608) 242-2800 or (855) 342-9900
After hours, weekends or holidays ask for the doctor on call. Leave your name and phone number with area code. We will call you back.