A vaginal fistula is a hole in the wall of the vagina. These holes usually create a passage to another part of the body, such as the bowels, colon or urinary tract. There are four kinds of vaginal fistulas: vesicovaginal, colovaginal, rectovaginal and enterovaginal. While a vaginal fistula is usually painless, but can cause embarrassing and potentially dangerous side effects in some cases.

The difference between the four types of fistulas is based on location of the hole between another body part and the vagina — vesicovaginal (urinary tract), colovaginal (colon), rectovaginal (rectum), and enterovaginal (small bowel). All are caused by tissue damage and do not happen spontaneously. Common causes for a vaginal fistula include inflammatory bowel disease, radiation treatment for cancer, pelvic surgery, or an injury related from a problematic childbirth. A vaginal fistula may not manifest itself for days or even years after the original damage to the tissue.

All kinds of fistulas cause vaginal irritation, and all but rectovaginal fistulas cause urinary incontinence, watery vaginal discharge and a leakage of urine through the vagina. Since rectovaginal fistulas are holes between the vagina and the rectum, its most common symptoms are fecal incontinence and feces leaking into the vagina.

When symptoms present themselves, a doctor will conduct several tests to discover the nature of the fistula. A dye test is frequently given first. In this test the bladder is filled with a dyed solution. The patient then passes the fluid while the doctor examines the vagina, looking for leakage. This test can usually detect the location of the fistula. The doctor will also usually use various scopes to inspect the vagina, ureters, bladder, anus and rectum. X-rays may also be taken to see if multiple fistulas are present.

Once a vaginal fistula diagnosis has been made, treatment can begin. In almost all cases, surgery is required to repair the damage. In the case of severe damage or dead tissue, the surgeon may introduce new tissue to help aide the recovery. More complicated procedures may be needed if the fistula was caused by a bowel diseases such as Crohn's. In these cases, a partial proctectomy — a surgical removal of a portion of the rectum — may be needed to prevent further complications. Additional treatment to help prevent further fistulas and help promote healing can include changes in diet and the addition of fiber supplements to improve bowel regularity.