Vaginal Fistula

About Vaginal Fistula

A vaginal fistula is an abnormal channel between the vagina and another nearby organ, most commonly the bladder, urethra, rectum or bowel. Fluids or stool can leak into the vagina, leading to constant moisture, hygiene problems, recurrent infections and significant emotional distress. Many women silently endure these symptoms before seeking specialist help at our Lucknow clinic.

Plastic surgery becomes involved when rectovaginal or recurrent vaginobladder fistulas have not healed despite surgery by gynaecologists or urologists. Higher abdominal fistulas are typically managed by urology and general surgery teams. Our role is to introduce healthy, well-vascularised tissue between the vagina and the affected organ, giving the repair a much better chance of holding.

Causes include obstetric trauma, prolonged or obstructed labour, surgery for prolapse or pelvic cancer, radiation therapy, infection, inflammatory bowel disease and accidental injury. Symptoms vary with location and size: leakage of urine or stool through the vagina, persistent foul discharge, recurrent infections, painful intercourse and skin irritation are common. A careful history quickly narrows down the type of fistula.

Diagnosis combines pelvic examination with a detailed surgical, obstetric and radiation history. Additional tests such as cystoscopy, colonoscopy, contrast studies, MRI or examination under anaesthesia may be needed to define the number, size and location of fistulas. Our team in Lucknow plans treatment around these findings and the patient's overall fitness, fertility wishes and prior surgeries.

For recurrent rectovaginal fistulas, Dr. Agarwal, FRCS Edinburgh, brings a healthy gracilis muscle and pedicled flap from the inner thigh and inserts it between the rectum and vagina, replacing scarred, inflamed tissue with well-vascularised muscle. Surgery is performed in lithotomy position under regional or general anaesthesia and typically takes one to two hours, with high success rates in carefully selected patients.

What to expect

• Confidential, sensitive consultation
• Detailed pelvic examination and history review
• Imaging, cystoscopy or colonoscopy as indicated
• Coordination with gynaecology and urology
• Gracilis or pedicled thigh flap reconstruction
• Surgery in lithotomy position under anaesthesia
• Structured follow-up to confirm fistula closure

Recovery

• Hospital stay of three to seven days
• Bowel rest or low-residue diet as advised
• Urinary catheter and dressings as prescribed
• Antibiotics and analgesics during early healing
• Avoid intercourse for several weeks
• Follow-up examination to confirm closure