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What Are Fistulas & How Are They Treated?

A fistula is a connection between two adjacent organs that is not supposed to be there, and they can develop in a multitude of areas around the body. For women, though, it’s the reproductive organs we’re talking about, as fistulas can and do develop in between the vagina and its next-door neighbors — the bladder and rectum. Here’s a quick rundown on this gynecological problem and what can be done about it.

Fistula 411

A fistula is an unnatural connection or conduit between two adjacent organs or parts of the body. They can develop between different organs, such as the neck and the throat, they can develop between an internal organ and the skin, such as bile ducts and the surface of the skin, and they can even develop between two blood vessels.

For our purposes, though, we’re focusing on fistulas that affect women exclusively. Dr. Natalie Sohn, an OB-GYN on staff at Tenet Florida Physician Services and Good Samaritan Medical Center in West Palm Beach, Florida, says fistulas can develop between the various parts of the reproductive tract — such as in between the vagina and the bladder or the vagina and the rectum. This leads to uncontrollable leakage of either urine or feces down and out through the vagina, which, as you can imagine, is the opposite of A-OK.

These types of fistulas can occur after trauma or infection, and for many women around the world, they are the result of childbirth — prolonged or traumatic labor or delivery can leave a mom with this persistent medical problem. It’s a particular issue in underdeveloped nations, Sohn notes. “In certain parts of Africa, fistulas are relatively common because of lack of medical care,” she explains. Fistulas can lead to women who are shunned socially and/or are unable to work outside the home.

Fistula treatment

A fistula, however, is a medical problem that can be treated, and the solution is surgery — which doesn’t seem to be a lot of fun, but it usually fixes the problem. “The tract or connective tubular areas need to be removed and the areas resewn,” says Sohn. “Sometimes the organs need to be ‘rested.’ For example, the bowel may have to be temporarily shunted to a colostomy while the vagina heals.”

This treatment can be a problem in areas where there isn’t as much medical care to be had, however. Lack of access to medical care, improper treatment of obstetrical tears or lack of funds compound the problem, and women are forced to live with gynecologic fistulas. There are currently programs that are raising awareness of this condition and efforts being made to help fund surgery for those affected.

One such effort is being led by Icon Undies, which are specifically designed for incontinence. This underwear not only helps keep you dry from occasional leakage, but your purchases directly impact women in developing countries who live with an obstetric or gynecologic fistula.

Worse yet, fewer than 20,000 are treated for the condition each year, which means many women live with the social stigma and major discomfort of constant, uncontrollable leaking. To that end, Icon has partnered with the Fistula Foundation to help fund life-changing surgery for some of these women (in 2017, 157 women were helped directly due to Icon Undies’ sales).

Fistulas are uncommon in developed countries due to medical advances, proper surgical techniques and adequate medical care, but they can still happen. Fortunately, treatment is available. For women who live in areas that may lack proper medical care, there is an ongoing effort to raise awareness and funds for diagnosis and treatment, so there is hope that someday, it will be less of a problem for women in developing countries.

What are fistulas and how are they treated?
Image: Getty Images/Design: Ashley Britton/SheKnows

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