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What is Bladder Fistulas?
Written by Medicover Team and Medically Reviewed by Dr Surya Nihar Seemakurty , Urologists
A bladder fistula occurs when an abnormal passage forms between the bladder and another organ, such as the bowel, vagina, or skin. This unwanted connection allows urine to leak into places it usually shouldn't, leading to symptoms like continuous urine leakage, infections, and discomfort.
It often requires medical or surgical treatment to restore normal urinary function. Understanding the mechanisms behind bladder fistula formation is essential for both patients and healthcare professionals.
Why It Matters?
Bladder fistulas can cause problems like:
- Constant urine leakage
- Repeated infections
- Foul-smelling urine or discharge
- Pain or irritation
How Does the Bladder Work?
The bladder is a muscular organ that stores urine from the kidneys. Urine travels through tubes called ureters into the bladder, where it's held until you're ready to urinate. When the bladder is full, nerves signal the brain, creating the urge to pee.
The bladder muscles then contract, and the sphincter muscles relax, allowing urine to be released through the urethra. This process is both automatic and under conscious control.
What are the Types of Bladder Fistulas?
Bladder fistulas are classified based on the abnormal connection between the bladder and another organ. Here are the most common types:
- Vesicovaginal Fistula: A connection between the bladder and vagina, often after childbirth or surgery, causing constant urine leakage.
- Enterovesical Fistula: Links the bladder to the intestine. Common with Crohn's disease or diverticulitis, it may cause UTIs, gas, or stool in the urine.
- Vesicocutaneous Fistula: Forms between the bladder and skin, leading to urine leakage through the skin, usually after surgery or infection.
- Vesicouterine Fistula: A rare link between the bladder and uterus, typically after a cesarean, causing unusual vaginal urine flow.
- Urethrovesical Fistula: A condition that connects the bladder and urethra, often resulting from trauma or surgery, leading to urine leakage.
What Are the Causes of Bladder Fistula?
Bladder fistulas usually develop due to injury, infection, surgery, or inflammatory diseases. Common causes include:
- Childbirth trauma, especially prolonged or obstructed labour
- Pelvic surgery, such as hysterectomy or bowel surgery
- Radiation therapy damages tissues and may lead to fistula formation.
- Infections: Severe or untreated urinary or pelvic infections
- Inflammatory diseases like Crohn's disease or diverticulitis
- Cancer: Tumours in the bladder, cervix, or colon can erode tissue and create openings
- Previous injuries: Pelvic fractures or catheter-related trauma may also cause fistulas.
These conditions weaken or damage the bladder wall, leading to the formation of an abnormal connection with nearby organs.
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Get Second OpinionWhat Are the Symptoms of Bladder Fistula?
Symptoms of a bladder fistula vary depending on where the fistula connects, but common signs include:
- Continuous urine leakage (especially from the vagina or skin)
- Frequent urinary tract infections (UTIs)
- Foul-smelling or cloudy urine
- Passing gas or stool in urine (if connected to the bowel)
- Pain during urination or pelvic discomfort
- Abnormal vaginal discharge (in women)
These symptoms often persist and do not improve with standard UTI treatments.
How is Bladder Fistula Diagnosed?
Diagnosing a bladder fistula involves a mix of medical history, physical exams, and tests to confirm the abnormal connection.
- Medical History and Symptoms: Your doctor will ask about urinary leakage, infections, past surgeries, childbirth, or radiation exposure.
- Urine Tests: Check for signs of infection, blood, or the presence of stool or gas in the urine.
- Dye Test (Methylene Blue Test): A colored dye is placed in the bladder to see if it leaks into the vagina or bowel.
- Cystoscopy: A thin camera is inserted into the bladder to view any fistula openings directly.
- Imaging tests, such as a CT scan, MRI, or ultrasound, help detect the location and size of the fistula and any related damage.
Early diagnosis helps guide proper treatment and prevents complications.
What Are the Treatment Options for Bladder Fistula?
Treatment for a bladder fistula focuses on closing the abnormal opening and treating any underlying cause. The right approach depends on the fistula's type, size, location, and cause.
Conservative Management (For Small or Early Fistulas)
- Catheter drainage: A catheter may be placed to keep the bladder empty and allow small fistulas to heal on their own.
- Antibiotics: Used to treat or prevent infection during healing.
- Nutritional support: Important in bowel-related fistulas, especially in people with Crohn's disease.
Surgical Repair (Most Common and Effective)
Surgery is often needed, especially for larger or long-standing fistulas.
- Fistula closure surgery: The abnormal opening is closed using healthy tissue from nearby areas.
- Minimally invasive approaches: Laparoscopic or robotic surgery may be used for faster recovery.
- Bowel or bladder repair: If the bowel or bladder is damaged, both organs may be repaired in the same surgery.
Additional Treatments (In Special Cases)
- Colostomy or ileostomy: Sometimes used temporarily to divert stool and allow healing in enterovesical fistulas.
- Treatment of the underlying disease, Such as Crohn's, cancer, or infection, to prevent recurrence.
Most patients recover well after treatment, especially with early diagnosis and expert care.
When to See a Doctor for a Bladder Fistula?
See a doctor right away if you notice any of the following symptoms:
- Constant urine leakage from the vagina, skin, or rectum
- Frequent or repeated urinary tract infections (UTIs)
- Foul-smelling or cloudy urine
- Passing gas or stool in urine
- Pain or burning during urination
- Unusual vaginal discharge (especially watery or urine-like)
These signs may point to a bladder fistula, especially if you've had recent surgery, childbirth, or radiation therapy. Early diagnosis and treatment can prevent complications and improve healing.
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After Treatment: What to Expect with Bladder Fistula Recovery?
Recovery after bladder fistula treatment depends on the type of fistula and the method used to repair it. Here's what patients can generally expect:
- Urinary catheter use: A catheter may be left in place for a few weeks to help the bladder heal.
- Follow-up visits: Regular checkups and imaging ensure proper healing and check for any signs of recurrence.
- Infection prevention: Antibiotics may be given to avoid infection during recovery.
- Diet and rest: Bowel rest or dietary changes may be recommended for enterovesical fistulas, particularly in cases of Crohn's disease.
- Healing time: Full recovery may take anywhere from a few weeks to several months, depending on the individual's specific case and overall health.
Most patients regain normal bladder function after successful treatment, with improved comfort and quality of life.
Our Experience in Treating Bladder Fistulas
At Medicover Hospitals, we have substantial experience in diagnosing and treating all types of bladder fistulas. Our team comprises expert urologists, gynecologists, and surgeons who collaborate to deliver the highest quality care.
We utilise modern diagnostic tools, including cystoscopy, ultrasound, CT scan, and MRI, to precisely locate the fistula. Depending on the case, we offer both non-surgical and surgical treatments, including minimally invasive options for faster healing.
Our goal is straightforward: to help patients recover fully, prevent future issues, and return to daily life with comfort and confidence.
