Introduction
Fistulas are a widespread problem that is not only found in the genital area. Usually a fistula describes a tubular connection between two hollow organs of the body. The two hollow organs are physiologically separated from each other and only by a concatenation of certain causes can both anatomical regions be connected.
Accordingly, the symptoms are very different and can be harmless or severe. In women, the cavities of the genital area mainly include the vagina but also the uterus. In men, fistulas with organs of the genital tract are very rare and unusual.
In women, fistula formations mainly affect the vaginal canal, which in most cases forms fistulas with parts of the intestine or parts of the urinary tract. In most cases, fistulas in the genital area do not constitute a medical emergency, in contrast to sometimes life-threatening arteriovenous fistulas. However, the effects of such fistulas can be very unpleasant for the women affected, which is why treatment is always indicated. The healing possibilities are very good, especially through surgical intervention. For more information on how fistulas in the bowel or anus can be treated, please see Fistula in the bowel and fistula at the anus
These are the causes of a fistula in the genital area
The causes for fistula formation can be numerous. However, they all have in common that there is a change in the intact vaginal wall, which can damage the wall structure in several planes. If there is close proximity to the bladder, the urinary tract or intestinal loops, the walls of the organs can fuse together in the following regeneration phase and form small tubular connections.
This manipulation is often caused by inflammation of the genital, urinary tract or intestine. In the genital area, these can mainly be fungal diseases, venereal diseases and other pathogen-related infections. In the intestinal area, fistula formation can also be attributed to pathogens, for example in the context of diverticulitis with inflamed protrusions of the colon.
Chronic inflammatory bowel diseases are also an important cause of fistula formation, especially Crohn’s disease and ulcerative colitis. Malignant tumors are another important cause of fistula formation. For example, bladder cancer, cervical cancer or rectal cancer can cause fistulas through their invasive growth through the organ walls.
Very rarely, malformations of this kind can be congenital in women. Both the fistula from the vagina to the intestine and the fistula to the bladder can occur as embryonic malformations. Apart from diseases of the organs, all accidents and injuries are also risk factors for fistula formation. Injuries to the intestinal or genital walls can occur, for example, during operations, childbirth, vaginal examinations or as a result of autoerotic accidents.
