What is the prognosis for genital fistula? | Fistula in the genital area – All you need to know

What is the prognosis for genital fistula?

The general prognosis in the treatment of fistulas is good. The success of treatment and the duration of the disease vary mainly with the size of the fistula. Large defects, especially of the intestine, may require weeks of treatment and a cure cannot be guaranteed.

Here, concomitant diseases such as Crohn’s disease in particular, but also underlying causative cancers, play an important role. In general, over 90% of fistulas can be cured in the first attempt at treatment. However, if the fistula reoccurs, the prognosis is worse, since the defective tissue increasingly loses its ability to heal as a result of previous operations.

How is a fistula in the genital area treated?

The treatment of the fistula depends on the size of the defect, but in most cases it must be surgically treated. Again, the distinction between the fistula to the bladder and the fistula to the bowel is crucial. A bladder fistula to the vagina can often heal by itself.

To support the healing process, it is advisable to drain the urine with the aid of a bladder catheter. This allows the fistula to heal without coming into contact with urine. This could otherwise prevent the tissue from healing optimally.Even after the fistula has been closed, urine should continue to be drained for a few days to protect the tissue until it has stabilized.

Even in the case of a fistula of the intestine to the vagina, it may be necessary to drain the stool away from the fistula until the healing process is complete. Since this involves a major intervention and the creation of an artificial bowel outlet, this method is only used in cases of major defects. A few weeks after the creation of the anus, the large fistula can be surgically treated.

Afterwards the tissue must heal well, which is not always guaranteed with certain previous illnesses. The rectal outlet can be relocated after the operation. However, if cancer or chronic inflammatory bowel disease is the cause of fistula formation, treatment of the underlying disease is an important part of the therapy.