What are Fistulas?

J. Beam

In medicine, fistulas are tube-like passageways that either form abnormally or are surgically created in the body. A fistula may connect to organs or vessels, or it might connect the surface of the skin to an internal organ or vessel. They may form abnormally in the body as a result of disease.

Surgically-created fistulas are sometimes created for patients undergoing prolonged treatments like dialysis.
Surgically-created fistulas are sometimes created for patients undergoing prolonged treatments like dialysis.

Generally, a fistula is described by its location in the body. For example, an arteriovenous (AV) fistula connects an artery and a vein. These are also a good example of a surgically created fistula intended for prolonged medical treatment, such as dialysis in patients with end-stage kidney failure.

A fistula is an abnormal connection between one organ or tissue and another organ or tissue.
A fistula is an abnormal connection between one organ or tissue and another organ or tissue.

Fistulas can form anywhere in the body, and there are three basic types, referred to as blind, complete, and incomplete. Blind fistulas have only one open end, while complete ones have openings externally and internally. Incomplete fistulas have an external opening but don’t attach to anything.

Trauma to the body, such as prolonged childbirth, can cause obstetric fistulas.
Trauma to the body, such as prolonged childbirth, can cause obstetric fistulas.

The causes of fistulas are varied. Diseases can cause them, as can certain medical treatments and trauma or injury to the body. Conditions such as Crohn’s disease and colitis are common inflammatory bowel diseases that cause anorectal fistulas. Trauma to the body, such as prolonged, severe childbirth, which can cause obstetric fistulas, can also be a culprit. Their formation as a result of severe childbirth occurs most often in parts of the world where professional medical care is either poor or non-existent.

Colitis is an inflammatory bowel disease that causes anorectal fistulas.
Colitis is an inflammatory bowel disease that causes anorectal fistulas.

Treatment of fistulas varies with the cause, location, size, and type. Some small ones that are the result of injury heal on their own in time. In some cases, if they are caused by a disease or condition, such as an infection, then treatment may involve antibiotics. If the fistula interferes with normal and necessary bodily functions, like blood flow, surgery to repair the opening may be necessary. Diagnosis varies with the location and type. Surgically created passages typically require a vascular surgeon and are closely monitored for healing and functionality.

Fistulas may develop as a result of trauma to the body's organs.
Fistulas may develop as a result of trauma to the body's organs.
Surgically-created fistula may be created for patients in kidney failure.
Surgically-created fistula may be created for patients in kidney failure.

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Discussion Comments

anon300433

How many types of fistula are there, because I know of someone who has a fistula not exactly at his anus, but at a distance, when he is sleeping you can even see it. He has had surgery twice now. Could it be that the operations were not successful? The last one was done in 2007, and it just started.

jennythelib

@anon5226 - I'm not familiar with this problem recurring, but it sounds like you should consult an OB/GYN. I can easily image how growing older and the stress of life could cause a recurrence.

Obstetric fistulas actually first came to my attention in a work of fiction: "Cutting for Stone," which my book group read. It was about a set of twins; one was a surgeon, and the other was a layperson who nonetheless made himself the world's foremost expert on fistulas.

It's not a pretty problem, and I understand that it can be very difficult to repair as the body's own tissues are worn away, but it is a life-changing surgery.

anon237454

Yes I had this problem and I had a successful surgery in 2004, and now by the grace of Allah, I am 100 percent fit.

anon144037

i have had at least ten surgeries in the past 17 years and i'm not getting better.

anon135257

Yes, my ex-wife. she died. post-natal fistulas often develop after lying in dormancy, and unfortunately, are often fatal. if you have waited years before seeing a doctor, it's probably too late. good luck though.

anon5226

Anyone ever had successful surgery for a fistula caused by childbirth and years later start symptoms again?

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